Hip Pelvis Thigh Flashcards
what do you always examen when the pt complains of knee pain
hip
what is trochanteric bursitis most commonly caused by
gait disturbances
how does trochanteric bursitis usually present
lateral hip pain over the outer thigh or difficulty with walking
presentation of osteonecrosis of the hip
Average age is <40
Groin pain or Buttock pain
“Deep and Throbbing” pain
Trendelenburg gait
what is LEGG CALVE PERTHES DISEASE
ISCHEMIA WITH SUBSEQUENT NECROSIS OF FEMORAL HEAD
AVN OF EPIPHYSIS, ABNORMAL GROWTH AT PHYSIS, REMODELING OF BONE
what is the usual age/sex for Legg Calve Perthes Dz
4-10 Y/O MALES
what can Legg Calve Perthes Dz lead to later in life
DJD
s/sxs of Legg Calve Perthes Dz
PAIN (GROIN/THIGH) POSSIBLE just KNEE PAIN EFFUSION LIMP/ANTALGIC GAIT LIMITED ABDUCTION AND INTERNAL ROTATION
dx of Legg Calve Perthes Dz
XRAYS ASAP
WILL NEED XRAYS OVER COURSE OF TREATMENT
tx of Legg Calve Perthes Dz
VERY YOUNG CHILD (2-6), W/ FEW XRAY CHANGES, USUALLY OBSERVATION
Usually better the outcome the younger they are
NSAIDS
CRUTCHES (HELPS LIMIT WB)
PT (IMPROVE ROM)
CASTING/BRACING OF PROGRESSIVE DEFORMITY
SURGERY (FEMORAL VS ACETABULAR OSTEOTOMY)
what is SLIPPED CAPITAL FEMORAL EPIPHYSIS (SCFE)
POSTERIOR INFERIOR DISPLACEMENT OF THE FEMORAL EPIPHYSIS THROUGH THE GROWTH PLATE
RF for SCFE
UNKNOWN CAUSE MORE COMMON IN MALES (AGES 11-15) OBESITY ENDOCRINE DISORDERS GRADUAL PROCESS BUT MAY BE DUE TO MINOR TRAUMA
s/sx of slipped capital femoral epiphysis
HIP OR KNEE PAIN
LIMP/PAIN WALKING
STIFFNESS OF HIP
EXTERNALLY ROTATED LEG
PE of slipped capital femoral epiphysis
PAINFUL, LIMITED ROM
XRAYS ALWAYS
AP PELVIS AND BILATERAL FROG LEG LATERAL VIEWS TO R/O OPPOSITE HIP INVOLVEMENT
tx of slipped capital femoral epiphysis
SURGERY
COMPLICATIONS: AVN
OA LATER IN LIFE
**ALWAYS watch later in life for the other hip
