Lecture 5B

Question 1

AVN (Legg Perthes) mainly affects what age?

Answer 1

2-8

“there will be Q on final about this” - Dr. A”

Question 2

What hip problem commonly affects newborns

Answer 2

congenital dislocation

Question 3

slipped capital epiphysis and osteochrondritis dissecans commonly affects what age

Answer 3

10-14

Question 4

Glute medius tendinopathy/tears commonly affects what age

Answer 4

Females 50+

Question 5

Stress fractures and FAI commonly affect what age

Answer 5

14-25

Question 6

How will the hip present with congenital hip dislocation

Answer 6

More females, L > R

Shortened limb, hip flexed and abducted

Limited Abd range of motion

Galeazzi sign and ortolani sign

Question 7

Pt presents with ache in hip, thigh, knee

observation: Shorter limb, higher greater trochanter, quad atrophy, adductor spasm

ROM: limited into abd and ext

gait: antalgic

Answer 7

legg calve perthes

Question 8

Gradual onset vague pain in knee, hip, and thigh. Pain with extreme motion

observaton: Shortened limb, obese, quad atrophy, adductor spasm, hip abducted and ER

ROM: limited IR, abd, and flexion

gait: antalgic during acute, tendelenberg sign w/ ER in chronic

Answer 8

slipped femoral capital epiphysis

Question 9

Urgent or emergent: Slipped Capital Epiphysis

Answer 9

Urgent: They can drive to ER or have someone drive them. Don’t need an ambulance

Question 10

Pt is 30-50, more likely male than female

Sharp pain or intermittent pain with extreme motion

ROM decreased

limping

Answer 10

avascular necrosis

Question 11

Pt is over 40, female

insidious onset, pain w/ weight bearing

often obese, joint crepitus

atrophy of gluteal muscles

limping

Answer 11

Degenerative joint disease

Question 12

Altman’s clinical criteria for hip OA

Dr A: This will be on final exam

Answer 12

Hip Pain

IR less than 15

Morning stiffness up to 60 mins

Age 50+

Question 13

Sutlive CPR for hip OA

4/5 present = 91% probability

Answer 13

1. Self- Reported Squatting is aggravating
2. Scour test w/ adduction causes groin or lateral hip pain
3. Active hip flexion causes lateral pain
4. Active hip ext causes lateral pain
5. Passive hip IR less or equal to 25 degrees

Question 14

Gradual onset (overuse)

Lateral hip, thigh,knee pain

snapping over greater trochanter

positive Ober’s test

Answer 14

ITB syndrome

Question 15

Pain over greater trochanter with resisted abduction

pain upon palpation

Answer 15

Trochanteric Bursitis

Question 16

Gradual onset, obese/pregnant

pain or paresthesia of anterior/lateral groin and thigh

Answer 16

Dx: Meralgia Paresthesia

Abnormal sensory exam of lateral femoral cutaneous nerve

Question 17

post-menopausal females, 50+

Aggravated by sleeping on side, stair climibng

Can occur after hip/knee surgery

Gluteal, quad, gastroc wasting

Answer 17

gluteus medius tendinopathy/tear

Question 18

Gluteus medius tendinopathy/tear pain is ____________

Answer 18

localized & load dependent

diffuse pain with low load is not tendinosis

Question 19

Acetabular/labral pathologies are common in ___________

Answer 19

highly active people 20-40

Question 20

Cam impingement vs Pincer impingement

Answer 20

Cam impingement - related to head/neck morphology

pincer impingement - acetabular overcoverage

Question 21

Pincer impingement usually presents with acetabular _____version

Answer 21

retroversion

Question 22

FAI w/ anterior-medial pain will have pain with:

Answer 22

flexion + IR

Question 23

FAI with posterior pain will have pain with:

Answer 23

Flexion, abduction, ER

Question 24

Military trainee with inability to passively rotate hip, history of increasing pain

mistaken for psoas tendonitis or adductor strain/hernia

Answer 24

Femoral stress fx

Question 25

The long axis manipulation happens in what hip position

What is the target

Answer 25

Open packed

Flexion, ER, Abd

target: overall capsule “Reset button”

may require 1+ to acheive goal

Question 26

The prone PA mobilization is for

Answer 26

anterior capsule: decreased ext

Question 27

Lateral hip mob is for:

Answer 27

lateral capsule, lack of horizontal ADD

Question 28

Inferior capsule mob with patient supine with hip flexed to painfree range is for…

Answer 28

loss of flexion

Question 29

When is the highest occurrence of re-straining a hamstring strain

Answer 29

Within the first 2 weeks of return to activities