Hip Pathologies

Question 1

Red flags in the hip (6)

Answer 1

• stress fracture
• avascular necrosis
• metastases
• RA
• fractured NOF
  -SUFE/Perthes disease

Question 2

what are
“- stress fracture
- avascular necrosis
- metastases “

Answer 2

SAM - red flags for hip

Question 3

other questions to ask for the hip (not red flags) (5)

Answer 3

squatting
crepitus
catching/locking
neurological syptoms
symptoms elsewhere

Question 4

2 types of hip OA

Answer 4

primary
secondary

Question 4

what is Primary OA

Answer 4

idiopathic

Question 4

what is Secondary OA

Answer 4

as a result of a disorder/event

Question 4

Mechanism of hip OA

Answer 4

progressive loss of articular cartilage, joint space narrowed, osteophytes (bone spurs), subchondral cysts, changes to the synovium

Question 4

hip OA is a ___ and ___ process

Answer 4

degenerative and reparative

Question 4

risk factors for OA (6)

Answer 4

• age ~60
• F>M
• genetics
• obesity (excessive adipose tissue)
• occupation
• previous injury (predispose, improper healing)

Question 4

OA clinical presentations SUB (5)
Hints: age, 24 hour pattern, pre-disposing factors

Answer 4

1. age>45
2. early morning stiffness in the hip <30mins
3. aching pain (groin)
4. pain on activity/ADLs (WB)
5. stiffness post-activity

Question 4

What mvmt can agg OA (2)

Answer 4

hip flexion and rotation

Question 5

OA clinical presentations OBJ (3)

Answer 5

1. altered gait
2. capsular pattern (flex, IR, ABD)
3. reduced ROM +/- pain on hip

Question 6

special test for hip OA (4)

Answer 6

quadrant test (pain)
FABER (pain)
FADDIR (pain)
trendelenburg (weakness around hip)

Question 7

functional test/mvmt for hip OA (4)

Answer 7

stairs, SLS, sit to stand, bridge

Question 8

hip OA management (main 3)

Answer 8

1. education and self-management
2. exercise
3. weight loss (if required)

Question 9

hip OA management (other options)

Answer 9

1. manage expectations, reassure and motivate
2. Manual therapy
3. analgesia
4. thermotherapy (heat, ice)
5. walking aids
6. stretching