L1 Hip Intro

Question 1

Resting position of hip joint

Answer 1

least tension on capsule and ligaments

30° of flexion, 30° of abduction, slight ER

Question 2

Closed pack position of hip

Answer 2

full extension, IR, and abduction

causes most amount of tension/stability within ligaments

Question 3

Capsular pattern of hip

Answer 3

flexion, abduction, IR

Question 4

Most congruent position of hip

Answer 4

flexion, abduction, ER

Question 5

Flexion norm of hip

Answer 5

120°

Question 6

Extension norm of hip

Answer 6

15-20°

Question 7

Abduction norm of hip

Answer 7

40°

Question 8

Adduction norm of hip

Answer 8

30°

Question 9

External Rotation norm of hip

Answer 9

30-60°

Question 10

Internal Rotation norm of hip

Answer 10

30-45°

Question 11

What action produces the most force on the hip?

Answer 11

Running

Walking up stairs causes more than just walking

Question 12

Legg-Calve Perthes age/sex

Answer 12

3-12 y/o
boys > girls

Question 13

Slipped Capital Femoral Epiphysis age/sex

Answer 13

11-13 girls, 13-15 y/o boys

Question 14

Labral lesions age

Answer 14

18-40 y/o

Question 15

Femoral/pelvic stress fractures age/sex

Answer 15

Young, female

Question 16

Osteoid osteoma age/sex

Answer 16

5-25 y/o, 2:1 M vs F

Question 17

Hip Osteoarthritis age/sex

Answer 17

> 50 y/o

Question 18

Gluteal Tendinopathy age/sex

Answer 18

> 40 y/o, female

Question 19

Synovial Chondromatosis age/sex

Answer 19

30-50 y/o, 2:1 M vs F

Question 20

Colon Cancer Red Flags

Answer 20

> 50 y/o, rectal bleeding, black stool, weight loss, family hx, pain not relieved with position changes

Question 21

Pathological Fx of Femoral Neck Red Flags

Answer 21

female >70 y/o, hip/groin/thigh pain, history of all from standing, severe/constant pain that is worse with any movement, shortened and externally rotated LE

Question 22

AVN of femoral head Red Flags

Answer 22

long term steroid use, alcohol abuse, trauma, hx of AVN on opposite side, gradual onset of pain, use of glucocorticoids

Question 23

Inguinal hernia red flags

Answer 23

-new lump in groin or other abdominal area
-may ache, non-tender to palpation
-increases in size with standing and coughing
-usually reducible by posture or manual

Question 24

Irreducible hernia red flags

Answer 24

bowel obstruction, nausea, vomiting, appears ill, fever

need to refer to ER immediately

Question 25

When to refer (red flag S/S)

Answer 25

trauma inability/unwillingness to bear weight severely antalgic gait observed deformity pain not relieved with rest systemic/constitutional symptoms

Question 26

Systemic S/S

Answer 26

disturbs sleep deep aching or throbbing reduced by pressure constant or waves of pain/spasm not aggravated by mechanical stress

Question 27

Mechanical S/S

Answer 27

generally lessens at night sharp or superficial ache usually decreases with cessation activity aggravated by mechanical stress

Question 28

Snapping sensation

Answer 28

extra-articular low pitched and feels deep IT band moving over the greater trochanter and iliopsoas moving over underlying bony prominences

Question 29

Clicking/popping

Answer 29

intra-articular high pitched sound indicates labral tears, ligamentum teres tears, loose bodies, general instability

Question 30

Giving way/giving out/weakness indicates

Answer 30

instability, fracture, pain inhibition

Question 31

Observation for Hip

Answer 31

Gait Posture Transfers

Question 32

Lumbar Clearing Tests

Answer 32

AROM = flexion, extension, lateral flexion, lumbar extension

Question 33

Important with lumbar clearing

Answer 33

1. Overpressure should not be applied in the case of acute/severe pain OR if AROM and/or repeated movements produced symptoms 2. Repeated movement testing not needed for quadrant testing (extension)

Question 34

Bony end feel

Answer 34

bone spur/OA, stops before normal ROM

Question 35

Soft capsular end feel

Answer 35

soft tissue edema

Question 36

Springy end feel

Answer 36

rebound movement, torn meniscus

Question 37

Empty end feel

Answer 37

pain before mechanical limitation, acute fracture

Question 38

Spasticity end feel

Answer 38

upper motor neuron lesion

Question 39

Squat test

Answer 39

feet shoulder width apart, as deep as they can go SN = .75 SP = .41

Question 40

Patrick's Test (FABER)

Answer 40

patient is supine PT stabilizes contralateral ASIS foot of limb to be tested placed just proximal to opposite patella testing limb overpressured into abduction/ER positive if it recreates their anterior/groin pain SN = .57, SP = .71, +LR = 1.9

Question 41

FADIR Test

Answer 41

passively flex, adduct, and IR to end range psoitive if it recreates their symptoms indicative of FAI SN = .78, SP = .10, -LR. =2.3