Hip Problems

Question 1

presentation of pain in hip pathology

Answer 1

pain in groin which may radiate to knee and buttocks

Question 2

first clinical sign of hip pathology

Answer 2

loss of internal rotation

Question 3

what does total hip replacement involve

Answer 3

stainless steel stem into femur and replace acetabulum with plastic cup

Question 4

how long are new hips expected to last

Answer 4

15 years

Question 5

early local complications of THR

Answer 5

infection
dislocation
nerve injury
leg length discrepancy

Question 6

general complications of THR

Answer 6

MI 
chest infection 
UTI 
blood loss and hypovolaemia 
DVT/PE

Question 7

late local complications of THR

Answer 7

early loosening

late infection or dislocation

Question 8

hanging rope sign on Xray

Answer 8

avascular necrosis
patchy sclerosis of weight bearing area of femoral head with a lytic zone underneath formed by granulation tissue from attempted repair

Question 9

features of trochanteric bursitis

Answer 9

pain and tenderness in the region of the greater trochanter with pain on resisted abduction

Question 10

shallow hip

Answer 10

hip dysplasia

Question 11

acetabular dysplasia

Answer 11

occurs when acetabulum is at wrong angle

Question 12

describe a cam hip

Answer 12

extra bit of bone on NOF which can cause impingement

Question 13

describe a pincer hip

Answer 13

acetabulum is bigger so encloses more of femoral head which can lead to impingement and eventually labrum tear (especially in athletes)

Question 14

what is done in avascular necrosis if it is caught early

Answer 14

drill into femoral head to reduce pressure and hopefully restore blood supply

Question 15

describe what happens in avascular necrosis

Answer 15

increased venous pressure in femoral head leads to somewhat of a compartment syndrome, cutting off the blood supply to trabecular bone of the femoral head
the head may collapse if this is not treated

Question 16

what causes OA

Answer 16

degeneration of the cartilage between joints

Question 17

what happens if the injury breaches the tidemark of the cartilage?

Answer 17

healing occurs because there is blood supply below this point

Question 18

features of OA

Answer 18

LOSS 
loss of joint space 
osteophytes 
subchondral cysts 
sclerosis