Hip Pathologies Flashcards
1
Q
Avascular Necrosis - SUBJECTIVE
A
- Deep groin pain, possibly referred to the thigh or buttock
- Pain worsens with weight-bearing or activity
- May have a history of corticosteroid use, alcohol abuse, trauma
2
Q
Avascular Necrosis - OBJECTIVE
A
- Limited active and passive range of motion (esp. internal rotation and abduction)
- Antalgic gait
- Pain with passive movement testing
- May appear normal early on; radiographic signs include crescent sign, femoral head collapse on MRI or X-ray
3
Q
Osteoarthritis - SUBJECTIVE
A
- Gradual onset groin or anterior thigh pain
- Morning stiffness (<30 mins)
- Pain worsens with activity and relieved by rest
4
Q
Osteoarthritis - OBJECTIVE
A
- Decreased hip active and passive ROM, esp. internal rotation and extension
- Pain at end range of motion
- Crepitus, joint line tenderness
- X-ray: joint space narrowing, osteophytes, subchondral sclerosis
5
Q
Neck of femur fracture - SUBJECTIVE
A
- Acute onset groin pain after trauma (usually fall in elderly)
- Inability to weight bear
6
Q
Neck of femur facture - OBJECTIVE
A
- Shortened, externally rotated leg
- Severe pain on hip movement:
○ Severely limited or absent active ROM due to pain
○ Passive ROM may elicit sharp pain - X-ray confirms fracture type (intracapsular/extracapsular)
7
Q
Greater Trochanteric pain syndrome - SUBJECTIVE
A
- Lateral hip pain, worse lying on affected side
- Pain with climbing stairs, prolonged standing or walking
8
Q
Greater Trochanteric pain syndrome - OBJECTIVE
A
- Tenderness over greater trochanter
- Pain with resisted hip abduction or external rotation
- Pain with passive adduction (compresses inflamed structures)
- General ROM often preserved unless severe
- Normal X-ray; MRI/US may show gluteal tendinopathy or bursitis
9
Q
Peri-prosthetic fracture - SUBJECTIVE
A
- Sudden pain in hip post-THR or revision surgery
- Often following trauma or fall
10
Q
Peri-prosthetic fracture - OBJECTIVE
A
- Pain, swelling, possible deformity around surgical site
- Inability to bear weight
- Severely limited active and passive ROM due to pain
- X-ray: fracture near prosthesis, often Vancouver classification used
11
Q
THR Dislocation - SUBJECTIVE
A
- Sudden pain and inability to move the hip after certain movement or trauma
- Sensation of “popping out”
12
Q
THR - OBJECTIVE
A
- Leg appears shortened and internally rotated (posterior dislocation)
- Limited or no active or passive ROM
- X-ray shows dislocated prosthetic head
13
Q
Hip Dysplasia - SUBJECTIVE
A
- Developmental history – often detected in infancy or early childhood
- In adults: hip instability, clicking, or pain
14
Q
Hip Dysplasia - OBJECTIVE
A
- Positive Ortolani/Barlow tests in infants
- Trendelenburg gait if symptomatic later (an abnormal walking pattern characterized by a pelvic drop on the side opposite the affected hip due to weakness or dysfunction)
- ROM in infants: Limited passive abduction
- ROM in adults: Limited active abduction or internal rotation
- Imaging: shallow acetabulum, subluxation/dislocation on X-ray or US
15
Q
Perthes disease - SUBJECTIVE
A
- Child aged 4–10 with limp and/or hip/groin pain
- Pain may refer to thigh or knee
16
Q
Perthes disease - OBJECTIVE
A
- Limited passive and active ROM, especially abduction and internal rotation
- Antalgic gait
- X-ray: flattened or fragmented femoral head
17
Q
Slipped upper femoral epiphysis - SUBJECTIVE
A
- Adolescent (typically obese male) with dull hip/groin/thigh/knee pain
- Gradual onset limp or sudden pain after minor trauma
18
Q
Slipped upper femoral epiphysis - OBJECTIVE
A
- Leg may be externally rotated
- Decreased active and passive internal rotation, flexion and abduction
- Obligatory external rotation during flexion
- X-ray: posterior/inferior displacement of femoral head (ice cream slipping off the cone appearance)
