Lecture 26 Orthopaedic Hip Conditions Flashcards
What is the function of the labrum
Adds stability and deepens the socket
What is Trochanteric Bursitis
Inflammation of bursa between hip abductors and IT Band
Is Trochanteric Bursitits more common in females or males?
Females
What are the causes of Trochanteric Bursitis
Trauma Over-use Abnormal movements Distant problem- scoliosis Local problem- total hip replacement, osteoarthritis, muscle wasting following surgery
What is the clinical presentation of Trochanteric Bursitis
Pain
Point tenderness
Lateral hip
During examination what would you look for Trochanteric Bursitis
Scars from previous surgery
Muscle wasting
Tenderness at greater Tuberosity
Worst pain in active abduction
What investigations are carried for suspected Trochanteric Bursitis
X-ray, MRI, US
What are the treatments for Trochanteric Bursitis
NSAIDS Rest Physiotherapy Corticosteroids injection (blindly or US) Surgery- Bursectomy
What is Avascular Necrosis
Death of the bone due to loss of blood supply
Is Avascular Necrosis more common in male or females
Males
35-50 years old
Avascular necrosis is normally unilateral or bilateral
Bilateral-80%
What are the risk factors for avascular necrosis
Trauma (Irradiation, fracture, dislocation, Iatrogenic)
Systemic (steroids, SCD, lymphoma, leukaemia)
Caisson’s Disease
Alcoholism
What are the symptoms of avascular necorsis
Insidious onset of groin pain
Pain with stairs, walking uphill and impact activities
Limp
How is avascular necrosis investigated
MRI
How is avascular necrosis treated
Crutches NSAIDs Bisphosphonates Anticoagulants Physiotherapy Surgical
What is Femoroacetabular Impingement (FAI)
2 surfaces hitting together
What is Femoroacetabular Impingement (FAI) the common causes of
o Hip pathology in younger patient
o Secondary osteoarthritis
o Anatomical phenomenon
Femoroacetabular Impingement (FAI) is split into two categories:
CAM lesion
Pincer
What is a CAM lesion
Slipped up femoral epiphysis
Deformity with neck of femur
Bony lump impinges on acetabulum
What is a Pincer
Acetabulum-based impingement
What does a Pincer lead to
Antersuperior acetabular rim overhang
Acetabular protrusion
Abutment of lesion on edge of acetabulum
Name 3 associated injuries with Femoroacetabular Impingement (FAI)
Labral degeneration and ters
Cartilage damage and flap tears
Secondary hip osteoarthritis
What are the clinical presentations of Femoroacetabular Impingement (FAI)
Groin pain Worse with flexion Pain with certain manoeuvres: • Getting out of a chair • Squatting • Lunging
Name investigations are done for Femoroacetabular Impingement (FAI)
Reduced flexion and internal rotation
Positive FADIR test
X-ray
MRI
