Lecture 5B Flashcards
newborn
congenital dislocation of hip
2-8 y/o
AVN (Legg Perthes)
children
hemophilia
10-14 y/o
slipped epiphysis, OR osteochondritis dissecans ( a small segment of bone and cartilage separates from the joint surface, typically due to lack of blood)
14-25 Y/O
stress fx, synovitis, FAI
young adult
muscle lesion, bursitis, synovitis, FAI
45-60 y/o
OA, synovitis
female 50+
Glute Med tendinopathy/tears
older adults
stress fx, OA, fx and post-replacement
65+
stress fx, OA
what can show in a radiograph indicating congenital hip dislocation?
upward and lateral displacement or delayed development of acetabulum
incidence of congenital hip dislocation
female>male; L>R
short limb, hip flexed and abducted
ROM: Limited ABD
tested via Galeazzi’s sign, Ortolani’s sign
what can show in a radiograph indicating Legg-calve-perthes?
increased density, fragmentation, flattening of epiphysis
legg calve perthes
age
indcidence
observation
ROM
Gait
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
PT intervention for legg-calve-perthes
PT: maintain ROM and positioning
surgery if PT fails
T/F legg calve perthes is a sudden onset with sharp pain at the hip/knee
false (gradual onset, aching pain at hip / knee)
what can show in a radiograph indicating SCFE?
displacement of upper femoral apiphysis, esp. in “frog position”
SCFE
incidence
observation
ROM
Gait
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
PT interventions for SCFE
NWB; requires surgery
SCFE ages
10-17y/o; Female 8-15 y/o
what can show in a radiograph indicating AVN?
flattening followed by collapseof femoral head
AVN
age
incidence
ROM
Gait
30-50 y/o
male>female
decreased
limp
symptoms of AVN
50% w/ sharp pain and 50% intermittent in extreme motion
PT interventions for AVN
Protected WB
PT appropriate w/exercise to maximize soft tissue function
Surgery with PT failure
symptoms of SCFE
Gradual onset, vague pain in knee, suprapatellar, thigh & hip; pain in extreme motion
DJD
age
incidence
observation
ROM
Gait
> 40
female>male
often obese, joint crepitus; mm atrophy of gluteal mm
limited ; capsular pattern
limp
T/F DJD is insidious onset, pain w/ weight bearing
T
what can show in a radiograph indicating DJD?
ncrease bone density, osteophytes, subarticular cysts, degenerative cartilage
DJD: PT interventions
NSAIDs, Modification of activity, AD?
PT manual therapy, exercise
Surgery-last resort
in DJD….
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
Altman criteria
Hip pain
IR <15 degrees
Pain with IR
Morning stiffness up to 60 minutes
Age >50 y/o**
Sutlive CPR for Presence of Hip OA
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!
KNOW THE TABLE SLIDE 14
DIFF DIX for hip OA
scour test, FABER, FADDIR, Fitzgerald, SIJ, Fem nerve provocation
