Hip & Pelvis Disorders

Question 1

Iliac Crest Contusion a.k.a.Hip Pointer

Answer 1

1.) A contusion at the site of or an avulsion of the quadratus lumborum and/or the abdominal muscles from the crest2.) Can be very painful and disabling especially if the periosteum is involved3.) Patient experiences pain when side bending away from the side of injury4.) Abduction of both legs together in the side-lying position will elicit pain5.) Etiology usually is trauma

Question 2

Bucket Handle Fracture

Answer 2

Superior and inferior pubic rami fractures with a separation or fracture of the contra-lateral SI joint

Question 3

Sprung Pelvis

Answer 3

Separation of the pubic symphysis and both SI joints

Question 4

Straddle Fracture

Answer 4

Bilateral superior pubic rami and ischiopubic fractures

Question 5

Legg-Calve-Perthes Disease

Answer 5

1.) Avascular necrosis of the femoral capital epiphysis before closure of the growth plate2.) Male 5:1 predominance3.) Ages 3-124.) History of painful limp, reduced mobility, muscle atrophy5.) Positive Trendelenberg Test6.) Primary causes: i.) Trauma ii.) Hereditary iii.) Nutritional iv.) Circulatory7.) Four stages (2-8 years) of the condition: i.) Avascularization ii.) Revascularization iii.) Repair iv.) Deformity

Question 6

Legg-Calve-Perthes Disease

Answer 6

1.) Avascular necrosis of the femoral capital epiphysis before closure of the growth plate2.) Male 5:1 predominance3.) Ages 3-124.) History of painful limp, reduced mobility, muscle atrophy5.) Positive Trendelenberg Test6.) Primary causes: i.) Trauma ii.) Hereditary iii.) Nutritional iv.) Circulatory7.) Four stages (2-8 years) of the condition: i.) Avascularization ii.) Revascularization iii.) Repair iv.) Deformity

Question 7

Osteoarthritisa.k.a.Degenerative Joint Disease

Answer 7

Primarily a disorder of hyaline cartilage and subchondral bone1.) Most common form of arthritis2.) Men and women equally affected3.) Incidence is after age 404.) No specific laboratory values5.) Deep, aching joint pain, particularly after exercise or weight bearing usually relieved by rest6.) Crepitation may be present on movement7.) Seen on x-ray as narrowing of joint space, cyst-like bony deposits in joint space, joint deformity due to degeneration or articular damage8.) Non-inflammatory usually involving one to a few joints

Question 8

Femoral Anteversion

Answer 8

1.) The angle between the femoral neck and the transcondylar axis is greater than 15 degrees2.) Toe-in gait3.) Increased femoral head torsion may result in the following conditions: a.) Osteoarthritis b.) Dysplasia of the acetabulum c.) Susceptibility to anterior femoral dislocation d.) Knee joint misalignment problems e.) Patellar dislocations f.) Excessive lumbar lordosis g.) External rotation of the tibia h.) Pronation of the feet

Question 9

Femoral Retroversion

Answer 9

1.) The angle between the femoral neck and the transcondylar axis is less than 15 degrees2.) Toe-out gait3.) Decreased femoral head torsion may result in the following conditions: a.) Low back or sacroiliac pathologies b.) Internal rotation of the tibia c.) Supination of the feet

Question 10

Slipped Femoral Capital Epiphysis

Answer 10

1.) Slipping of the neck on the femoral head as the head remains in the acetabulum2.) Adolescent ages 10-153.) Males more than females4.) Blacks more than whites5.) Left hip more than right hip6.) Bilateral more common in females7.) Tendency to be with overweight adolescent8.) Onset of limp with hip pain referred to the knee9.) Etiology is trauma 50% of the time10.) Alteration in Klein’s line