Hip Ultrasound Flashcards
Origin of gluteal muscles
posterior surface of ileum,
GLuteus minimus inserti
anterior facet of greater trochanter
glut medius insertion
supero posterior facets
glut max insertion
posterior femur, gluteal tuberosity below the trochanters and Iliotibial tract
sartorius origin
ASIS
Rectus femoris origin
AIIS
semimembranosus tendon and conjoint tendon orientation
semimembranosus tendon is anterior to conjoined tendon…. semimem origin is anterolateral to conjoint tendon
Hesselbach triangle landmark
apex laterallly - inferior epigastric vessels , inguinal ligament inferiorly, medial border is rectus abdominis
sportsman hernia pathological part
common aponeurosis
Spigelian hernia area
between rectus abdominis and lateral abdominal musculature ,
Lateral margin of rectus abdominis
Origin of indirect head of rectus femoris
laterally at the superior acetabular ridge
which rectus femoris head becomes a central aponeurosis
indirect head.
muscle superficial to the femoral artery
sartorius
order of appearance of adductor muscles
AL AB AM a
Saphenous nerve location. muscular landmark
deep to sartorius
superficial to gracilis
S
N
G
what comprises triangle of sciatic nerve
semimembranosus medial, sciatic lateral are the base… apex is the conjoined tendon of BF and ST
Between which muscles can you find the obturator nerve?
adductor muscles
Gracilis muscle orientation relative to adductors?
superficial and more medial to adductors
Differentiate ortolani from Barlows
barlow- dislocate using adduction and posteriorly directed force,
Ortolani - relocation using abduction and anteriorly directed force
Name landmarks for DDH scan and typical appearance
egg on spoon, Ilium, acetabulum= alpha angle. should be >60. ilium and labrum angle = beta angle should be <55 degrees
Criteria for joint distention/effusion in kids and adults in hip
2mm A-P separation - pedia
Adult= 7mm distention. or 1mm asymmetry between contralateral
What hip position improves visualziation of hip effusion
leg extension and abduction
What happens with a large body habitus to echogenicity of fluid
can cause anechoic fluid to appear ARTIFICALLY Hypoechoic or ISOechoic
Causes of synovial hypertrophy
Infection, inflammatory arthritis, PVNS,osteochondromatosis ( with hyperechoic calcifications)
Differentiate labral degeneration from tear
degeneration - diffuse hypoechogenicity,
tear-defined hypoechoic or anechoic cleft
Dynamic evaluation fo femoroacetabular impingement and tx?
hip flexion and internal rotation- direct contact between labral tear and cortical irregularity– osteoplasty
Is the hypoechogenicity superior to a arthroplaty prosthesis normal?
yes
What is a thigh splint?
adductor insertion avulsion syndrome from chronic repetitive stress injury, WOF periostitis or possible stress fracture?
Where is the insertion of the adductor longus
posteromedial femur
Differentiate benign enlargement lymph node from malignant
benign- maintained oval shape, hyperechoic hilum. Malignant- ROUND, absence or narrowed hilum, thickening of cortex
Role of US in sarcoma?
to monitor for recurrence.
Benign differentials of a palpable mass - msk related
pseudohypertrophy of TFL, chronic retracted tenon or muscle tear
If unstable hips when to do US exam?
younger than 2 weeks
If stable hips when to do US
4-6 weeks if there is stable click
if normal PE, but with risk factors when to scan
4-6 weeks
Angulation criteria for DDH
Alpha- <60 Beta >77
