hip region Flashcards
what should you consider if pt in an infant
congenital hip dysplasia
what should you consider if pt in an elderly
osteoporotic femoral neck fractures
OA and RA
what to consider if pt is a young female
CHD
what to consider if pt is a young male
LCPD and SCFE
discuss the clinical presentation of CHD
mostly common in female infants; either hip dislocation or subluxation
LOM and limb shortening; possible limp and waddling gait
discuss the clinical presentation of LCPD
most common in thin, tall boys 3-12 yrs old; osteonecrosis of femoral head d/t poor blood supply
limp, pain that can be reffered to the knee, LOM abd and IR, atrophy
discuss the clinical presentation of SCFE
most common in obese boys 10-16
can be assoc w trauma or chronic; limp and affected limb is shoter and smaller
LOM in abd and IR and obligatory ER ( FADDER) is present
what to consider if pt landed on the outside of hip
trochanteric bursitis
what to consider if pt landed on the knee thus jarring of hip
subluxation or labral tear
what to consider if pt has Hx of repetitive stress and loading to the hip
femoral stress fracture, osteoporotic changes related injuries or insufficiency injuries
possible conditions if pain is felt at the anterior hip
arthritis, hip flexor strain, iliopsoas bursitis, labral tear
possible conditions if pain is felt at the lateral hip
greater troch bursitis, gluts med tear, ITB syndrome, snapping hip, meralgia paresthetica
possible conditions if pain is felt at the posterior hip
hip extensor or ER pathology, degenerative disc disease and spinal stenosis can be reffered
possible conditions if gradual onset
RA, OA, tuberculosis of hip
possible conditions if sudden onset
fractures, muscle tear/sprain, labral tear, disloc, instab
what to consider if pain radiates from hip, posterior thigh and leg into the foot
sciatica or piriformis syndrome
what to consider if pain radiates from hip to groin
inguinal hernia or groin strain
possible cause of dull, deep, aching pain
arthritis or Paget’s
possible cause of sharp, intense, sudden and c weight bearing pain
fracture
possible cause of tingling that radiates
radiculopathy, spinal stenosis, meralgia parasthetica
possible cause of inc pain c sitting c affected leg crossed
trochanteric bursitis
possible cause of inc pain c sitting c affected leg not crossed
ischiogluteal bursitis
possible cause of pain on attempted WB
occult fracture or severe arthrosis
possible cause of pain after standing or walking
hip arthrosis
possible cause of pain unremitting and long duration
Paget’s, metastatic carcinoma, severe arthrosis minsan
discuss hip intra-articular pain
can be labral tears or anterior impingement
felt mainly at groin and along anterior or medial thigh to the knee
discuss buttock pain
can be posterior labral tear, lumbar spine affectation
discuss adductor pain
over active adductors assoc c pelvic instab
limb attitude of synovitis
mild flexion, abd, ER c apparent lengthening
limb attitude of true arthritis
FADIR c or s true shortening
limb attitude of posterior disloc
FADIR c apparent or true shortening
limb attitude of anterior disloc
FABER c apparent lengthening
limb attitude of NOF or troch affectation
ER but more in troch affectation
discuss internal snapping
iliopsoas tendon over lesser troch or ant acetabulum or ilifemoral ligament over femoral head
snaps at 45° flexion from extension esp w ABER
discuss external snapping
tight ITB or gluts mac tendon that rides over greater troch
snaps during hip flexion and extension esp c IR
discuss intra-articular snapping
20-40 yrs old d/t labral tears, loose bodies, trauma or degeneration
sharp pain into groin and ant thigh esp c pivoting movements
