Hip Pathlogies Flashcards
What is the myositis ossificans presentation and cause
presentation- direct blow followed by swelling and decreeased ability to flex knee
cause- dame to mm with hematoma
What is a hip pointer, cause, prognosis
Disabling contusion of iliac crest due to direct trauma/fall on hard surface
prog- normally 3 weeks
what is the mc hip dislocation, how does ant and post dislocations present
post mc (car accident)– medical emergency!
post- flex adducted, int rot
ant- ext rot, abducted, flex or extend
cause of atruamatic hip instability and possible symptoms
cause- repetative microtrauma from axial loading and ext rot.
symptoms- pain, psoas/it snapping, apprehension, instability
what are the 3 types of bursistis (mc)
Tracnteric (mc)
Ischial (prox hamstring origin)
Iliopectineal (deep to psoas tendon)
what is a better diagnosis than trochanteric bursitis and what does it include
Greater trochanteric pain syndrome
including trochanteric bursitis, thickening/thinning/tears or tendinopathy of the gluteals and external coxa saltans (snapping hip)
What is gluteal tendinopathy mc in and ways to dx
females 40+, 35% of those w low back pain
dx via palpation, provocation, RROM, obers, faber
tx of greater trochanteric pain syndrome
- anti inflammatory measures (rice)
- soft tissue work (not over bursae)
- Corticosteroid injections
What is the presentation of snapping hip syndrome, mc pop, pathology
presentation- snapping sensation with fear of dislocation
mc- in younger women
pathology- tendons become inflamed.irrated from rubbing over bursae/bony prominances
Adductor strain- cause,mc mm involved, tests
forecefull contraction in stretched pos
mc- adductor longus/magnus
tests- Direct palp, resisted adduction, passive abduction
Hamstring strain- moi, what makes the injury worse
moi- forced flex at hip with knee extenion or excessive contraction
More prox injury the longer recovery
ext hip rotator strain- moi, symptoms
moi- overuse, lack of ext rot flex/mobility with int contracture of hip
symptoms- vague butt pain with resisted ext rot, may cause sciatic nerve compression (piriformis syndrome)
Piriformis syndrome- moi, symptoms
moi- contracture (overuse), prolonged ext pressure,congenital variations
symptoms- butt pain, pain w sitting, tenderness over greater sciatic notch, increased pain with maneuvers that place piriformis under tension.
What is the pathology of a sports hernia and presentation
- bulge/ post inguinal wall hernia w/o presentation of true hernia due to abnormalities in RA, partial avulsion of IO from pubic tubercle
pres- generally high performance athletes (men in 20s)
What are the symptoms of a sports hernia
-inguinal canal pain that is chronic, insidious and intermittent (increase w coughing,straining,twisting), usually after strenous actiuty
How to assess for sports hernia
Squeeze knees/feet together while suprine
resisted sit up
moi, Presentation, dx of osteitis pubis
moi- Forced adduction
pres- pain w activity (localized to pubic region)
dx- xray- widening at he pubis (>10mm), iregularity/sclerosis of pubic margins
Presentation of hip stress fx and mc pop
pres- insidious, deep ant pain with weight bearing, possible limp, night pain
mc- young and active pts. (distance runners etc)
Hip fx risks
malunion, AVN, biomechanical problems
Presentation of hip osteoarthritis, mc age, pain loc
Middle age to elderly
- Modertate ant/lat hip pain, pain w standing
- Moring stiffness >1hr
- LBP from compensation
- trendelenburg
tx of hip osteoarthritus + prog
- reduce inflammatory response
- keep them moving and maintain WB function
- lose weight/activity modification
prog- if left untreated, natural history is progressive and can lead to severe disability/jt replacement
common pop that is affected by rheumatoid arthritis + presentation
women 25-55, bilateral pain, periarticular swelling
-likely has hands/wrist involvent (ulnar dev)
What is the pathology of rheumatoid arthritis
Chronic synovial inflammation results in jt destruction
what % of hip pain does acetabular labral tears account for and moi
22-55% of hip groin pain
moi- rot + hyperextension or repeated pivoting/twisting
