hip region

Question 1

what should you consider if pt in an infant

Answer 1

congenital hip dysplasia

Question 2

what should you consider if pt in an elderly

Answer 2

osteoporotic femoral neck fractures

OA and RA

Question 3

what to consider if pt is a young female

Answer 3

CHD

Question 4

what to consider if pt is a young male

Answer 4

LCPD and SCFE

Question 5

discuss the clinical presentation of CHD

Answer 5

mostly common in female infants; either hip dislocation or subluxation

LOM and limb shortening; possible limp and waddling gait

Question 6

discuss the clinical presentation of LCPD

Answer 6

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

Question 7

discuss the clinical presentation of SCFE

Answer 7

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

Question 8

what to consider if pt landed on the outside of hip

Answer 8

trochanteric bursitis

Question 9

what to consider if pt landed on the knee thus jarring of hip

Answer 9

subluxation or labral tear

Question 10

what to consider if pt has Hx of repetitive stress and loading to the hip

Answer 10

femoral stress fracture, osteoporotic changes related injuries or insufficiency injuries

Question 11

possible conditions if pain is felt at the anterior hip

Answer 11

arthritis, hip flexor strain, iliopsoas bursitis, labral tear

Question 12

possible conditions if pain is felt at the lateral hip

Answer 12

greater troch bursitis, gluts med tear, ITB syndrome, snapping hip, meralgia paresthetica

Question 13

possible conditions if pain is felt at the posterior hip

Answer 13

hip extensor or ER pathology, degenerative disc disease and spinal stenosis can be reffered

Question 14

possible conditions if gradual onset

Answer 14

RA, OA, tuberculosis of hip

Question 15

possible conditions if sudden onset

Answer 15

fractures, muscle tear/sprain, labral tear, disloc, instab

Question 16

what to consider if pain radiates from hip, posterior thigh and leg into the foot

Answer 16

sciatica or piriformis syndrome

Question 17

what to consider if pain radiates from hip to groin

Answer 17

inguinal hernia or groin strain

Question 18

possible cause of dull, deep, aching pain

Answer 18

arthritis or Paget’s

Question 19

possible cause of sharp, intense, sudden and c weight bearing pain

Answer 19

fracture

Question 20

possible cause of tingling that radiates

Answer 20

radiculopathy, spinal stenosis, meralgia parasthetica

Question 21

possible cause of inc pain c sitting c affected leg crossed

Answer 21

trochanteric bursitis

Question 22

possible cause of inc pain c sitting c affected leg not crossed

Answer 22

ischiogluteal bursitis

Question 23

possible cause of pain on attempted WB

Answer 23

occult fracture or severe arthrosis

Question 24

possible cause of pain after standing or walking

Answer 24

hip arthrosis

Question 25

possible cause of pain unremitting and long duration

Answer 25

Paget’s, metastatic carcinoma, severe arthrosis minsan

Question 26

discuss hip intra-articular pain

Answer 26

can be labral tears or anterior impingement

felt mainly at groin and along anterior or medial thigh to the knee

Question 27

discuss buttock pain

Answer 27

can be posterior labral tear, lumbar spine affectation

Question 28

discuss adductor pain

Answer 28

over active adductors assoc c pelvic instab

Question 29

limb attitude of synovitis

Answer 29

mild flexion, abd, ER c apparent lengthening

Question 30

limb attitude of true arthritis

Answer 30

FADIR c or s true shortening

Question 31

limb attitude of posterior disloc

Answer 31

FADIR c apparent or true shortening

Question 32

limb attitude of anterior disloc

Answer 32

FABER c apparent lengthening

Question 33

limb attitude of NOF or troch affectation

Answer 33

ER but more in troch affectation

Question 34

discuss internal snapping

Answer 34

iliopsoas tendon over lesser troch or ant acetabulum or ilifemoral ligament over femoral head

snaps at 45° flexion from extension esp w ABER

Question 35

discuss external snapping

Answer 35

tight ITB or gluts mac tendon that rides over greater troch

snaps during hip flexion and extension esp c IR

Question 36

discuss intra-articular snapping

Answer 36

20-40 yrs old d/t labral tears, loose bodies, trauma or degeneration

sharp pain into groin and ant thigh esp c pivoting movements