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MSK > Hip Pathology > Flashcards

Hip Pathology Flashcards

1
Q

Name four pathologies of the hip

A
  • femoroacetabular impingement syndrome
  • avascular necrosis
  • idiopathic transient osteonecrosis
  • trochanter bursitis
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2
Q

What is femoroacetabular impingement syndrome?

A

Altered morphology of the femoral neck/acetabulum causes abutment of the femoral neck on the acetabulum during movement

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3
Q

Name the three types of femoroacetabular impingement

A

CAM
Pincer
Mixed

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4
Q

Describe CAM impingement

A

Femoral deformity usually in young male athletes asymmetric femoral head with decreased head;neck

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5
Q

Describe pincer impingement

A

Acetabular deformity usually in females

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6
Q

What does disease does impingement cause?

A

Damage to the labrum and cartilage leading to osteoarthritis

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7
Q

How does impingement present?

A

Activity related groin pain - flexion and rotation
Difficulty sitting down
C sign positive

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8
Q

How is impingement diagnosed?

A

X-ray
CT
MRI

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9
Q

Describe the management for impingement?

A

OA - replacement

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10
Q

What is avascular necrosis?

A

Failure of blood supply to femoral head

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11
Q

Name the causes of avascular necrosis

A

Idiopathic

Secondary to: irradiation, haematological disorders, diabetes, alcohol, steroids, trauma

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12
Q

Describe the pathophysiology of avascular necrosis

A

Coagulation leads to venous thrombosis and hypertension which reduces blood flow to the femoral head causing necrosis and chrondral fracture

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13
Q

How will avascular necrosis present?

A

Insidious onset of groin pain
Exacerbated by stairs
Normal examination

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14
Q

How is avascular necrosis diagnosed?

A

MRI
Xray
Patchy sclerosis with lytic zone formed by granulation tissue - hanging rope sign

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15
Q

Describe the management of avascular necrosis

A

Reversible - medication, bone graft, decompression

Irreversible - hip replacement

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16
Q

What is idiopathic transient osteonecrosis?

A

Local hyperaemia and impaired venous return with marrow oedema and increased intramedullary pressure

17
Q

How will idiopathic transient osteonecrosis present?

A

Pain over groin, difficulty weight bearing
Middle aged men
Pregnant women in third trimester

18
Q

How is idiopathic transient osteonecrosis diagnosed?

A

Increased ESR
Radiographs
MRI
Bone scan

19
Q

Describe the management for idiopathic osteonecrosis

A

Self limiting 6-9 months
Analgesia
Protection

20
Q

What is tronchanteric bursitis?

A

Repetitive trauma caused by IT band tracking over trochanteric bursa causing inflammation

21
Q

How does tronchanteric bursitis present?

A

Pain on lateral aspect of hip and palpation of greater trochanter

22
Q

How is tronchanteric bursitis diagnosed?

A

MRI possible but usually clinical

23
Q

How is tronchanteric bursitis managed?

A

Analgesia, NSAIDs, physio, steroids

MSK (22 decks)

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