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PCM Midterm > Hip ppt > Flashcards

Hip ppt Flashcards

1
Q

What is the minimum palpation for every pt with hip pain?

A

iliac crest at L4
anterior superior iliac crest
greater trochanter

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2
Q

musculoskeletal differential for anterior hip pain

A

meralgia paresthesia

sports hernias

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3
Q

musculoskeletal differential for anterolateral hip pain

A 
femoroacetabular impingement
hip labral tear
legg calve perthes disease
osteoarthritis
osteonecrosis of hip
septic hip
slipped capital femoral epiphysis
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4
Q

musculoskeletal differential for lateral hip pain

A

external snapping hip

greater trochanteric bursitis

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5
Q

musculoskeletal differential for posterolateral hip pain

A

gluteal muscle tear

iliac crest apophysis avulsion

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6
Q

musculoskeletal differential for posterior hip pain

A

hamstring strain
ischiofemoral impingement
piriformis syndrome
sacroiliac joint dysfunction

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7
Q

What do you perform the FABER test to test?

A

labral tear, loose bodies, chondral lesions, femoral acetabular impingement, osteoarthritis, sacroiliac joint dysfunction, iliopsoas bursitis

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8
Q

When do you use the FABER test?

A

anterolateral/anterior hip pain

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9
Q

When do you use the FADIR test?

A

anterior hip pain

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10
Q

What does the FADIR test test for?

A

labral tear, loose bodies, chondral lesions, femoral acetabular impingement

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11
Q

What does the log roll test for?

A

piriformis syndrome

SCFE

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12
Q

What does the straight leg raise test test for?

A

sports hernia
SCFE
femoral acetabular impingement

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13
Q

When do you use the straight leg raise test?

A

anterior/anteriolateral hip pain

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14
Q

When do you use the Ober test?

A

lateral hip pain

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15
Q

What is the Ober test for?

A

external snapping hip, greater trochanteric pain syndrome

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16
Q

What does the Trendelenburg gait indicate?

A

labral tear, transient synovitis, Legg-Calve-Perthes disease

gluteus medius m

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17
Q

What is the Thomas test for?

A

tendinopathy, rectus femoris tear, fractures

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18
Q

What is the PACE test/FAIR test for?

A

piriformis syndrome

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19
Q

development dysplasia of the hip tests

A

Ortolani test - abducting forward
Barlow - adducting posteriorly
+ clunk or dislocation
needs bracing, US hip to confirm

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20
Q

trochanteric bursitis
Where is the pain?
risk factors

A

most common cause of lateral hip pain, over greater trochanter
tendinopathy of the gluteus minimus and medius, also involves inflammation of bursa
female gender, obesity, knee pain, IT band tenderness, low back pain

21
Q

PE finding for trochanteric bursitis

A

lateral hip pain, especially when lying on affected side, local tenderness on the greater trochanter
specialty test: may have + FABER and Ober tests

22
Q

osteonecrosis of hip
causes
mechanism

A

medications (longterm steroid use), medical conditions (sickle cell anemia, SLE), trauma, transplantation
decreased or poor blood supply, mechanical trauma, genetic factors, metabolic factors

23
Q

PE findings for osteonecrosis of hip

A

groin pain, pain with activity, pain at rest

my be asymptomatic after a while

24
Q

imaging for osteonecrosis of hip

A

XR initially

MRI

25
Q

treatment of osteonecrosis of hip

A

medications: bisphosphonates (can cause osteonecrosis of jaw), vasodilators, statin (lipid lower drugs), anticoagulation
osteotomy
grafting
surgical fixation (total hip replacement)

26
Q

Legg-Calve-Perthes disease
who does it affect?
risk factors

A

idiopathic avascular necrosis of the hip, decreased perfusion to the femoral head
affects children 3 - 12 yo, males>females
skeletal immaturity, obesity, lower socioeconomic status

27
Q

PE findings Legg-Calve-Perthes disease

A

acute or insidious onset of pain with limping, decreased ROM or stiffness

28
Q

imaging for Legg-Calve-Perthes disease

A

XR shows osteochondral loose bodies

29
Q

treatment for Legg-Calve-perthes disease

A

nonweightbearing with sling, surgery

30
Q

slipped capital femoral epiphysis (SCFE)

cause/risk factor

A

pain and limitation in movement of limb due to femoral epiphysis that slipped posteriorly
obesity in adolescent (8-15 yo) growth spurt, endocrine disorder

31
Q

SCFE PE findings

A

obese adolescent presenting with hip pain with limping and impaired internal rotation, occasionally after minor trauma

32
Q

imaging for SCFE

A

AP or lateral view XR of hip, US, MRI

33
Q

treatment for SCFE

A

nonweight bearing with crutches or wheelchair, refer to ortho
surgery to stabilize and prevent complications

34
Q

femoraoacetabular impingement

A

pain on anterolateral hip/groin due to abnormal contact btwn the anterior femoral head and acetabular rim
can increase risk of osteoarthiritis of hip

35
Q

PE findings of femoraoacetabular impingement

A

pain increased with prolonged sitting, leaning forward, getting out of car
insidious pain in groin area and buttocks

36
Q

specialty testing for femoraoacetabular impingement

A

C-sign, positive FABER and FADIR test

37
Q

treatment for femoraoacetabular impingement

A

physical therapy
inraarticular injection
arthroscopy

38
Q

acetabular labral tear
causes
can hasten…

A

pain on anterior aspect of hip
post trauma or insidious in onset (from longterm microtrauma)
…osteoarthritis

39
Q

PE findings of acetabular labral tear

specialty test

A

pain with activity

+ Thomas test

40
Q

imaging for acetabular labral tear

A

MR arthrography

41
Q

treatment for acetabular labral tear

A

joint injection and hip arthroscopy

42
Q

What are common organisms for septic arthritis?
healthy people
immunocompromised pt

A

healthy: staph aureus and streptococcal, N gonorrhea
immunocompromised: gram - bacteria, mycobacterial species, fungal species

43
Q

piriformis syndrome

causes

A

entrapment of the sciatic N resulting in pain on buttock
may develop after trauma to buttock or piriformis muscle causing strain and scarring around the nerve
structure of piriformis muscle

44
Q

PE findings of piriformis syndrome

specialty test

A 
buttock pain and paresthesia
wallet sign: pain with sitting on wallet
neurologic exam normal
\+ log roll test
\+ PACE test/FAIR test
45
Q

treatment for piriformis syndrome

A

physical therapy

nerve pain medications

46
Q

meralgia paresthetica

causes

A

compression of the lateral femoral cutaneous nerve as it passes through the inguinal ligament
pain on the lateral aspect of hip and thigh
tight fitting clothes, obesity, DM, pregnancy

47
Q

PE findings of meralgia paresthica

specialty test

A

numbness and tingling or decreased sensation over the lateral hip and thigh
+ FABER

48
Q

treatment for meralgia paresthetica

A

conservative therapy
nerve block
nerve pain with neuropathic pain

PCM Midterm (9 decks)

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