Hip pain

Question 1

what is the hip joint commonly affected by in older patients?

Answer 1

DJD

fracture

Question 2

disorders of the hip are commonly..

Answer 2

age ralated

Question 3

if an infant has a hip disorder it is most likely

Answer 3

congential

Question 4

when does an adolescent have hip problems?

Answer 4

vascular and growth plate problems

Question 5

when does a young adult have hip problems?

Answer 5

traumatic injuries

Question 6

diagnosis of hip pain is often dependant on?

Answer 6

radiographs

Question 7

hip pain can be from?

Answer 7

intrinsic pathology or referred

Question 8

what can help identify the hip pain?

Answer 8

associated pain in lumbopelvic region or abdominal areas

Question 9

insidious onset of hip pain suggests?

Answer 9

DJD if in adult/senior

AVN, SCFE, reactive synovitis if child or adolescent

Question 10

what must you assess if a child has hip pain?

Answer 10

knee

Question 11

direct trauma that causes thigh pain is due to?

Answer 11

contusion

Question 12

sudden onset of thigh pain with movement

Answer 12

strain

Question 13

anterior numbness, paresthesias or weakness in the thigh area?

Answer 13

femoral nerve involvement

Question 14

lateral sensory complaints in the thigh

Answer 14

lateral femoral cutaneous nerve involvement or trigger point referral

Question 15

posterior neurological complaints of thigh pain

Answer 15

sciatic nerve irritation, referral from trigger points or lumbar/sacral facet problem

Question 16

anteversion

Answer 16

femoral head faces forward with relative posteiror positioning of the greater trochanter

Question 17

retroversion

Answer 17

femoral head faces posterior with positioning of the greater trochanter anteirorly

Question 18

femoral angle

Answer 18

120-130 degrees

Question 19

what tests can be used to evaluate hip pain?

Answer 19

fabre patrick’s
axial compression
femoral acetabular impingement tests
thomas test

Question 20

DJD/OA

Answer 20

narrowing of the superior joint space with osteophyte formation, cystic change, sclerosis

Question 21

RA

Answer 21

uniform, symmetrical loss of joint space with demineralization, cystic change, acetabular protrusion

Question 22

paget’s disease

Answer 22

accentuate trabeculation, cortical thickening, brim sign, bone softening changes

Question 23

AVN

Answer 23

mottled bone density, crescent sign, flattening deformity, fragmentation

Question 24

legg-calve perthes disease

Answer 24

small or absent epiphysis, flattening, sclerosis, fissuring, fragmentation, mushroom deformity

Question 25

SCFE

Answer 25

abnormal Klein's line

Question 26

developmental dysplasia of the hip

Answer 26

putti's triad

Question 27

FAI

Answer 27

aspherical head of the femoral head, lack of femoral head neck offset and retroversion of the acetabulum

Question 28

acetabular dysplasia

Answer 28

increased inclination of the acetabulum

Question 29

what hip pathologies require medical referral

Answer 29

fracture, dislocation, SCFE, AVN, infection, tumor or visceral pathlogy

Question 30

classic presentation of hip fracture

Answer 30

pain unable to bear weight history of a fall onto hip

Question 31

elderly with hip fractures is usually due to?

Answer 31

osteoporosis

Question 32

what are the types of hip fractures?

Answer 32

intracapsular (subcapital, transcervical, basicervical) | extracapsular (intertrochanteric, subtrochanteric

Question 33

stress fractureclassic presentation

Answer 33

young active patient, often participating in actiities such as long distance running, gymnastics, etc pain is insidious and worse with weight bearing

Question 34

impaction fracture

Answer 34

shortened height, causing a zone of sclerosis

Question 35

insufficiency fracture

Answer 35

normal stress to an abnormal bone

Question 36

what are the clasic tests for early detection of congenital hip dislocation?

Answer 36

ortolani's | barlow's

Question 37

radiographic examination of congenital hip dysplasia may reveal?

Answer 37

putti's triad

Question 38

what needs to happen if someone does have congenital hip dislocation?

Answer 38

orthopedic consult

Question 39

putti's triad

Answer 39

small/absent proximal femoral epiphysis lateral displacement of the femur increased inclination of acetabular roof

Question 40

what lines are used to check for congenitlal hip dysplasia?

Answer 40

shenton's hilgenreiner's perkin's

Question 41

perkin's line and hilgenreiner's line should equal out to?

Answer 41

28 degrees or less

Question 42

ddx of dysplasia of the hip

Answer 42

SCFE congenital hip dysplasia AVN

Question 43

if the femur head looks inferior on the film, what kind of dislocation is it?

Answer 43

anterior

Question 44

if the femur head looks superior on the film, what kind of dislocation is it?

Answer 44

posterior

Question 45

posterior hip dislocation

Answer 45

90% of sports related hip dislocations major iforce is applied to a flexed abducted hip, after the injuryy the hip is held in flexion, adduction and internal rotation

Question 46

anteiror hip dislocation

Answer 46

force to an extended, externally rotated leg, after the injury the leg is held in felxion, abudction and internal rotation

Question 47

who usually gets SCFE?

Answer 47

overweight child or young rapidly growing adolescent

Question 48

s/s of SCFE

Answer 48

``` possible hormonal influcences bilateral occurances common pain with limp children may only have knee pain abnormal kline's line ```

Question 49

what is the next step for a SCFE?

Answer 49

orthopedic consult

Question 50

s/s of AVN

Answer 50

mild hip pain with associated limp of insidious onset young patient may have knee pain may have limited hip abduction and internal rotaiton positive trendelenburg tes

Question 51

etiology of AVN

Answer 51

disruption of vasuclar supply related to an undetermined etiology or trauma, long-term steroid use, hyperlipidemia, alcoholism, pancreatitis, hemoglobinopathies, etc

Question 52

legg-calve-perthes

Answer 52

small or absent femoral capital epiphysis, fissuring, fragmentation, flattening, mottled density, sclerosis, crescent sign

Question 53

adult AVN

Answer 53

mottled density change, flattening, crescent sign, sclerosis, fragmentation

Question 54

AVNs need?

Answer 54

MRI | orthopedic consult

Question 55

femoral acetabular impingement syndrome

Answer 55

clinical syndrome of painfully limited hip motion result of certain types of underlying morphological abnormalities in the femoral head/neck region and/or surrounding acetabulum lead to early degenerative disease and labral tears

Question 56

s/s of femoral acetabular impingement syndrome

Answer 56

sharp, deep hip pain with squatting ,running, stopping and starting or changing direction may also cause pain pain is often felt anteirorly

Question 57

etiology of femoral acetabular impingement syndrome

Answer 57

different types of hip abnormalities that limit motion, in particular flexion and internal rotation

Question 58

pincer impingement

Answer 58

more common in middle aged women, occuring at an average of 40 years, and can occur with various disorders

Question 59

CAM impingement

Answer 59

more common in young men, occuring at an average age of 32 years

Question 60

CAM type

Answer 60

abnormalities of the femur wiht decreased offset between the femoral head and neck

Question 61

pincer type

Answer 61

due to acetabular abnromalities which lead to excessive coverage by the anteiror acebatular rim