Lecture 5B

Question 1

newborn

Answer 1

congenital dislocation of hip

Question 2

2-8 y/o

Answer 2

AVN (Legg Perthes)

Question 3

children

Answer 3

hemophilia

Question 4

10-14 y/o

Answer 4

slipped epiphysis, OR osteochondritis dissecans ( a small segment of bone and cartilage separates from the joint surface, typically due to lack of blood)

Question 5

14-25 Y/O

Answer 5

stress fx, synovitis, FAI

Question 6

young adult

Answer 6

muscle lesion, bursitis, synovitis, FAI

Question 7

45-60 y/o

Answer 7

OA, synovitis

Question 8

female 50+

Answer 8

Glute Med tendinopathy/tears

Question 9

older adults

Answer 9

stress fx, OA, fx and post-replacement

Question 10

65+

Answer 10

stress fx, OA

Question 11

what can show in a radiograph indicating congenital hip dislocation?

Answer 11

upward and lateral displacement or delayed development of acetabulum

Question 12

incidence of congenital hip dislocation

Answer 12

female>male; L>R

short limb, hip flexed and abducted

ROM: Limited ABD

tested via Galeazzi’s sign, Ortolani’s sign

Question 13

what can show in a radiograph indicating Legg-calve-perthes?

Answer 13

increased density, fragmentation, flattening of epiphysis

Question 14

legg calve perthes

age
indcidence
observation
ROM
Gait

Answer 14

2-13 y/o
male>female, 15% B
short limb, higher greater torch, quad atrophy, adductor spasm
limited abd and ext
antalgic gait after activity

Question 15

PT intervention for legg-calve-perthes

Answer 15

PT: maintain ROM and positioning

surgery if PT fails

Question 16

T/F legg calve perthes is a sudden onset with sharp pain at the hip/knee

Answer 16

false (gradual onset, aching pain at hip / knee)

Question 17

what can show in a radiograph indicating SCFE?

Answer 17

displacement of upper femoral apiphysis, esp. in “frog position”

Question 18

SCFE

incidence
observation
ROM
Gait

Answer 18

male>female
short limb, usually obses, quad atrophy, adductor spasm, hip abducted and ER
limited IR, abd, flexion
antalgic in actue; trendelebern sign w/ ER in chronic

Question 19

PT interventions for SCFE

Answer 19

NWB; requires surgery

Question 20

SCFE ages

Answer 20

10-17y/o; Female 8-15 y/o

Question 21

what can show in a radiograph indicating AVN?

Answer 21

flattening followed by collapseof femoral head

Question 22

AVN

age
incidence
ROM
Gait

Answer 22

30-50 y/o
male>female
decreased
limp

Question 23

symptoms of AVN

Answer 23

50% w/ sharp pain and 50% intermittent in extreme motion

Question 24

PT interventions for AVN

Answer 24

Protected WB
PT appropriate w/exercise to maximize soft tissue function
Surgery with PT failure

Question 25

symptoms of SCFE

Answer 25

Gradual onset, vague pain in knee, suprapatellar, thigh & hip; pain in extreme motion

Question 26

DJD

age
incidence
observation
ROM
Gait

Answer 26

> 40
female>male
often obese, joint crepitus; mm atrophy of gluteal mm
limited ; capsular pattern
limp

Question 27

T/F DJD is insidious onset, pain w/ weight bearing

Answer 27

T

Question 28

what can show in a radiograph indicating DJD?

Answer 28

ncrease bone density, osteophytes, subarticular cysts, degenerative cartilage

Question 29

DJD: PT interventions

Answer 29

NSAIDs, Modification of activity, AD?
PT manual therapy, exercise
Surgery-last resort

Question 30

in DJD….

Answer 30

location of the spur will tell you ROM deficit, so this one would limit abduction, sitting cross legged may be an unattainable goal, modification may be necessary

Question 31

Altman criteria

Answer 31

Hip pain
IR <15 degrees
Pain with IR
Morning stiffness up to 60 minutes
Age >50 y/o**

Question 32

Sutlive CPR for Presence of Hip OA

Answer 32

Self-reported squatting is aggravating
Scour Test with adduction causes groin or lateral hip pain
Active hip flexion causes lateral pain
Active hip extension causing hip pain
Passive hip IR less than or equal to 25 degrees

3/5 present=68% probability
4/5 present=91% probability!

Question 33

KNOW THE TABLE SLIDE 14

Question 34

DIFF DIX for hip OA

Answer 34

scour test, FABER, FADDIR, Fitzgerald, SIJ, Fem nerve provocation