Hip & Pelvis Anomalies & Variants

Question 1

What are phleboliths?

Answer 1

Calcified venous thrombi

Question 2

What is the clinical significance of phleboliths?

Answer 2

None

Question 3

How are phleboliths differentiated from kidney stones?

Answer 3

• kidney stones = above ischial spine + painful
• phleboliths = below ischial spine + low pain

Question 4

What are paraglenoid sulci?

Answer 4

Notches next to SI joints that occur primarily in females (rare)

Question 5

What is developmental dysplasia of the hip (DDH)?

Answer 5

ranges from shallow acetabulum to fully dislocating

Question 6

What is Putti’s Triad?

Answer 6

Used to determine DDH:
- shallow acetabulum
- small femoral head
- lateral displacement of femur

Question 7

What orthopedic tests are used to test for DDH in infants?

Answer 7

Ortolani & Barlow

Question 8

What is the clinical significance of DDH?

Answer 8

concern for AVN & premature hip DJD
(management is conservative to operative)

Question 9

What pathologic gait may a patient with DDH present with?

Answer 9

Trendelenburg gait

Question 10

What is coxa vara?

Answer 10

femoral neck shaft angle = <120 degrees
(lowercase “r”)

Question 11

What is coxa valga?

Answer 11

femoral neck shaft angle = >130 degrees
(lowercase “l”)

Question 12

What is the term for the Y-shaped epiphyseal plate at junction of ilium, ischium, and pubis in the immature skeleton?

Answer 12

Triradiate cartilage

Question 13

What is Fong syndrome?

Answer 13

Isolated finding of iliac horns found on posterior

Question 14

What diagnosis is associated with Fong syndrome?

Answer 14

Nail-Patella syndrome
(abnormal finger/toenails + hypoplastic laterally displaced patella)

Question 15

What is an ischial apophysis?

Answer 15

curved secondary apophysis of the ischial tuberosity, seen between 12-16 yrs

Question 16

What is an iliac apophysis?

Answer 16

secondary ossification center along wing of ilium

Question 17

What is Femoroacetabular Impingement Syndrome (FAI)?

Answer 17

abnormal shape of FA joint resulting in mechanical impingement + pain

Question 18

How is FAI diagnosed?

Answer 18

clinical Dx (shape + Sx)
NOT Dx with imaging

Question 19

What are the types of FAI?

Answer 19

Cam
Pincer
(can also have mixed)

Question 20

What is Cam type FAI?

Answer 20

oblong protrusion on femoral neck

Question 21

What is Pincer type FAI?

Answer 21

deep acetabular socket

Question 22

What is an Os Acetabuli?

Answer 22

accessory ossicle of acetabular margin, with smooth, well-rounded, corticated margins (not a Fx)

Question 23

What is the clinical significance of an Os acetabuli?

Answer 23

not clinically significant (can be asymptomatic -> FAI)

Question 24

What is another name for Femoral Herniation Pits?

Answer 24

Pitt Pits

Question 25

What are Femoral herniation pits?

Answer 25

cyst-like lesions;
another clue to labral problems secondary to FAI

Question 26

What is Ward triangle?

Answer 26

radiolucent area between trabecular patterns in the femur

Question 27

What are the 3 trabecular patterns in the femur?

Answer 27

• principle compressive
• secondary compressive
• primary tensile

Question 28

What is the diagnosis?

Answer 28

Phleboliths

Question 29

What is the diagnosis?

Answer 29

Paraglenoid sulci

Question 30

What is the diagnosis?

Answer 30

DDH

Question 31

What is the diagnosis?

Answer 31

Coxa vara

Question 32

What is the diagnosis?

Answer 32

DDH

Question 33

What is the diagnosis?

Answer 33

Coxa valga

Question 34

What is the diagnosis?

Answer 34

Fong syndrome

Question 35

Assuming this patient is symptomatic, what is the diagnosis?

Answer 35

FAI Cam type

Question 36

Assuming this patient is symptomatic, what is the diagnosis?

Answer 36

FAI Pincer type

Question 37

What is the diagnosis?

Answer 37

Os acetabuli

Question 38

What is the diagnosis?

Answer 38

Os acetabuli

Question 39

Name 2 diagnoses.

Answer 39

Femoral neck Fx
Pitt pits

Question 40

What is the diagnosis?

Answer 40

Pitt pits