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Diff Dx > Hip pain > Flashcards

Hip pain Flashcards

1
Q

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

A

DJD

fracture

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2
Q

disorders of the hip are commonly..

A

age ralated

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3
Q

if an infant has a hip disorder it is most likely

A

congential

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4
Q

when does an adolescent have hip problems?

A

vascular and growth plate problems

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5
Q

when does a young adult have hip problems?

A

traumatic injuries

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6
Q

diagnosis of hip pain is often dependant on?

A

radiographs

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7
Q

hip pain can be from?

A

intrinsic pathology or referred

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8
Q

what can help identify the hip pain?

A

associated pain in lumbopelvic region or abdominal areas

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9
Q

insidious onset of hip pain suggests?

A

DJD if in adult/senior

AVN, SCFE, reactive synovitis if child or adolescent

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10
Q

what must you assess if a child has hip pain?

A

knee

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11
Q

direct trauma that causes thigh pain is due to?

A

contusion

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12
Q

sudden onset of thigh pain with movement

A

strain

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13
Q

anterior numbness, paresthesias or weakness in the thigh area?

A

femoral nerve involvement

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14
Q

lateral sensory complaints in the thigh

A

lateral femoral cutaneous nerve involvement or trigger point referral

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15
Q

posterior neurological complaints of thigh pain

A

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

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16
Q

anteversion

A

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

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17
Q

retroversion

A

femoral head faces posterior with positioning of the greater trochanter anteirorly

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18
Q

femoral angle

A

120-130 degrees

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19
Q

what tests can be used to evaluate hip pain?

A

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

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20
Q

DJD/OA

A

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

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21
Q

RA

A

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

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22
Q

paget’s disease

A

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

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23
Q

AVN

A

mottled bone density, crescent sign, flattening deformity, fragmentation

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24
Q

legg-calve perthes disease

A

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

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25
Q

SCFE

A

abnormal Klein’s line

26
Q

developmental dysplasia of the hip

A

putti’s triad

27
Q

FAI

A

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

28
Q

acetabular dysplasia

A

increased inclination of the acetabulum

29
Q

what hip pathologies require medical referral

A

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

30
Q

classic presentation of hip fracture

A

pain
unable to bear weight
history of a fall onto hip

31
Q

elderly with hip fractures is usually due to?

A

osteoporosis

32
Q

what are the types of hip fractures?

A

intracapsular (subcapital, transcervical, basicervical)

extracapsular (intertrochanteric, subtrochanteric

33
Q

stress fractureclassic presentation

A

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

34
Q

impaction fracture

A

shortened height, causing a zone of sclerosis

35
Q

insufficiency fracture

A

normal stress to an abnormal bone

36
Q

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

A

ortolani’s

barlow’s

37
Q

radiographic examination of congenital hip dysplasia may reveal?

A

putti’s triad

38
Q

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

A

orthopedic consult

39
Q

putti’s triad

A

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

40
Q

what lines are used to check for congenitlal hip dysplasia?

A

shenton’s
hilgenreiner’s
perkin’s

41
Q

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

A

28 degrees or less

42
Q

ddx of dysplasia of the hip

A

SCFE
congenital hip dysplasia
AVN

43
Q

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

A

anterior

44
Q

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

A

posterior

45
Q

posterior hip dislocation

A

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

46
Q

anteiror hip dislocation

A

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

47
Q

who usually gets SCFE?

A

overweight child or young rapidly growing adolescent

48
Q

s/s of SCFE

A 
possible hormonal influcences
bilateral occurances common
pain with limp
children may only have knee pain
abnormal kline's line
49
Q

what is the next step for a SCFE?

A

orthopedic consult

50
Q

s/s of AVN

A

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

51
Q

etiology of AVN

A

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

52
Q

legg-calve-perthes

A

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

53
Q

adult AVN

A

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

54
Q

AVNs need?

A

MRI

orthopedic consult

55
Q

femoral acetabular impingement syndrome

A

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

56
Q

s/s of femoral acetabular impingement syndrome

A

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

57
Q

etiology of femoral acetabular impingement syndrome

A

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

58
Q

pincer impingement

A

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

59
Q

CAM impingement

A

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

60
Q

CAM type

A

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

61
Q

pincer type

A

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

Diff Dx (17 decks)

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