Hip Pain Flashcards
Where can buttock pain be referred from?
Lumbosacral spine
Hip joint
Where can pain in the groin be referred from?
Hip joint
Lumbosacral spine
SI joint
Where can pain in the anterior thigh be referred from?
Hip
Where can pain in the lateral pelvis be referred from?
Gluteal muscles
Trochanteric bursa
What determines the risk of steroid related avascular necrosis?
Total dose of steroids (not time or maximum dose at one time)
What are some ways to assess the severity of hip pain?
The amount of analgesics taken
Impairment to daily activities
Pain at rest
Waking up at night
What is the WOMAC score?
Assess of disability caused by pain using
Pain
Stiffness
Mobility
What are some pain scoring systems for hip?
MAPT
Oxford hip score
WOMAC
What is disceptive about pathology at the hip joint?
It’s deep so signs of inflammation are usually masked
- But very painful on movement
What is the GALS?
Gait Arms Legs Spine - screening MSK examination
What can inferred from a negative Thomas’ test?
A patient’s OA, if present, is not significant
What pathologies can cause a positive trendelenberg test?
Inhibition by pain
Muscle weakness
Neuromuscular problem
What are some signs of OA in the hip on examination?
Limited ROM esp extension, IR, and ER
What are possible findings on OA xray?
Loss of joint space and cartilage
Osteophyte formation
Subchondral sclerosis
Subchondral cysts
What are the analgesics of choice in OA?
Paracetamol in the long term
Aspirin in the early stage when there is still an inflammatory component
Do intra-articular steroid injection work in OA?
In some patients yes
But there is diminishing returns
What are the indications for total hip replacements?
Disabling pain with failed non-operative treatment
- Disabling painful hip joint at rest and at night
- Severely deformed hip - decreased ROM and function, impaired ADLs
What is the maximum length that a leg can be increased?
3cm
What are the small external rotators of the hip
Piriformis
Gemelli inferior and superior
Obturator internus
What is done prior to orthopaedic surgery to minimise infection risk?
Screen for UTI and MRSA and attempt to eradicate
Why is a ECG performed prior to THR surgery?
Baseline
Which pathology will mean that a spinal anaesthetic is contraindicated?
Aortic stenosis
