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MSK: LQ > lecture 5B:hip join examination ,, evualatin and interventions > Flashcards

lecture 5B:hip join examination ,, evualatin and interventions Flashcards

1
Q

what is a common hip pathologie in a

new born
children
young adults
older adults

A

new born: congenital dislocation of hip
children: hemophilia
young adults : mm lesion , bursitis . synovitis , FAI
older adults: stress fx , OA , Fx and post op replacement

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2
Q

what age group is AVN (legg perthes) a common hip path in

A

2-8 year old

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3
Q

what is a common hip path for ages 10-14

A

slipped epiphysis, osteochondritis dissecans

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4
Q

what is a common hip path for ages 14-25

A

stres fx , synovitis and FAI

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5
Q

what is a common hip path for ages 45-60

A

OA , synovitis

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6
Q

glute medium tendinopathy/tears is more common in what age group

A

females over 50

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7
Q

what is a common hip path for ages 65+

A

stress fx nad OA

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8
Q

is congenital hip dislocaiton more common in male or females ? and R or L hip

A

females in the L hip

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9
Q

what is the observation for congenital hip dislocation

A

short limb
hip flex
abducted

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10
Q

what ROM is limited and what is the special test for congential hip dislocation

A

limited abd

special test: Galeazzi’s sign, Ortolani’s sign

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11
Q

what age is legg-calve-perthes common in ? and is it higher in males or females

A

2-13 y/o
more common in male

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12
Q

how is the onset for LCP and where is there an ache at

A

gradual onset of, ache in hip, thigh and knee

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13
Q

what is the observation for *legg-cal-per**

A

short limb
higher GT
quad atrophy
adductor spasm

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14
Q

what ROM is limited and what kind of gait do kids with Legg-Calve-Perthes have

A

limited abd and ext

gait is antalgic after activity

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15
Q

what will the radiographic show for Legg-Calve-Perthes

A

increased density , fragmentation , flattening of epiphysis

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16
Q

what is the main intervention for Legg-Calve-Perthes

A

PT: maintain ROM and position

if fail then sx

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17
Q

what age is slipped femoral capital epiphysis common in for males and a females

A

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

higher incidence in males

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18
Q

what is the onset for SFCE and where is the pain

A

gradual onset of
vague pain in knee , suprapateller , thigh and hight

pain in extreme motin

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19
Q

what is the observation from SFCE

A

short limb
usually obese
quad atrophy
adductor spasm
hip abducted and ER

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20
Q

what ROM is limited and waht is the gait for SFCE

A

limited IR , abd and flex

antalgic in acute ; trendelenburg sign w ER in chronic

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21
Q

what is the intervention for SFCE

A

NWB

needs sx

refer to urgent care

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22
Q

if a 8yeard old male patient comes into clinic and they describe having a gradual onset of achyness in the hip , thigh and knee. you observed them and see they have a short limb , higher GT , some wand atrophy and adductor spams as well has limited ABD and EXT what hip path do u think they have

A

legg calve perthes

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23
Q

a 15 year old male patients comes in and complains of a gradual onset off vague pain in his knee , suprapatellar , thigh and hip so u observe him and note he has a short limb , kinda over weight , some quad atrophy , adductor spasm anf his hip is abducted and er …. u also not he has an antalgic gate .,, what hip path do u think he has

A

slipped femoral capital epiphysis and u need to refer him NOE

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24
Q

what age and gender is avascular necrosis common in

A

males ; 30-50

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25
what is the ROM and gait fro someone with **avascular necrosis**
decreased ROM limp gait
26
what is the intervention for **avascular necrosis**
protected WB PT exercise is to maximize soft tissue function
27
what is the age and gender the **DJD** is most common in
> 40 y/o females
28
how is the onset for **dJd** and when is there pain
insidious onset pain with WB
29
what is the observation , ROM and gait from DJD
observation: often fat , joint crepitus; muscle atrophy of gluteal muscles • ROM: limited, capsular pattern • Gait: limp
30
what is the intervention for someone with DJD
NSAIDS Manual therapy sx last resort
31
if a 45 year old females walking into clinic adn complains of an insidious onset of pain with WB and u observe she has joint creptus , mm atrophy of gluteal mm , limited capsulr pattern ROM of the him and x-rays that show increase bone density , osteophytes , sub articular cysts .. what hip path do u think it is
DJD
32
what is **Altman’s Clinical Criteria for Hip OA** (5)
* Hip pain * IR <15 degrees * Pain with IR * Morning stiffness up to 60 minutes * Age >50 y/o
33
what is Sutlive CPR for Presence of Hip OA (5)
• 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 4/5 is 91% probability
34
what are the 4 things that are **ranked “A”** for **CPG’s for hip pain** and **mobility** deficits - hip OA
-risk factors -diagnosis/classification - examination; outcome measures -examination ; activity limitation and participation restriction measures
35
what is **patient educations** grade for CPG’s for hip pain and mobility deficits - hip OA
B
36
what is **manual therapy** for CPG’s for hip pain and mobility deficits - hip OA
B
37
what is **flexibiltiy , strengthening, and endurance exercises** graded for CPG’s for hip pain and mobility deficits - hip OA
B
38
what is **pathoanatomical features** for CPG’s for hip pain and mobility deficits - hip OA
B
39
what is **functional gait and balance training** graded for CPG’s for hip pain and mobility deficits - hip OA
C
40
what physcial examination measures may be helpful int he differential diagnosis process when differentiation hip pain from other sources of pain ? (6)
- scour test FABER -fitzgerald test - FADIR -SIJ provocation test - femoral nerve stretch
41
for **total hip arthoplasty** patients when do u do these things * Progressive strengthening * Mobilization (gentle) into limited ranges (typically extension) * Soft tissue and neural mobility * Advanced gait activities with/without AD * BALANCE training
in OP
42
for a THA pt when do u consider these things • Prevent DVTs • Initiate HEP/gait training/transfers • THR precautions • Home equipment recommendations
acute care
43
what mm’s are likely to have a mm strain
hammy RF adductor longus
44
**ITB syndrome** what is .. - onset: -S&S: -special test:
- onset : gradual -S&S: laterla hip ,thigh or knee pian snapping IT band over GT -special test: obers
45
where is there pain for a trochanteric burtitis
pain over GT w resisted abduction pain on palpation of GT
46
what is the treatment for **ITB syndrome**
* Modification of activity * Footwear * Stretching & strengthening exercises * NSAIDs
47
what is the treatment for **trochanteric bursitis**
* Ice * NSAIDs * IT band stretching * Protection from direct trauma * Steroid injection
48
for **myositis ossificans** what is.. HX: S&S: imaging:
* Hx: direct trauma; contusion w/ hematoma 2-4 weeks prior * S&S: pain on palpation & motions; ecchymosis * Imaging: X-ray or US
49
what is the treatment from **myositis ossifcans**
* Ice * NSAIDs * Stretching * If PT fails → orthopedic surgery
50
for **meralgia parasthesia** what is … HX: S&S: where do they have abd normal sensory examination over
* Hx: gradual onset, often obese & pregnant women * S&S: pain or paresthesia of anterior or lateral groin & thigh distraction of lateral femoral cutaneous nerves
51
what should u avoid during treatment and what is appropriate from meralgia parasthesia
avoid external compression of nerves nerve glides as appropriate
52
what is a common soft tissue injures in post menopausal females usually >50 y/o and has aggravating factors like stair clinging , sleeping on side .. u observe gluteal , quad and gastro wasting
gluteus medius tendinopathy/tear
53
what is the main difference between gluteal medius tendinopathy/teat from a trochanteric bursitis and from hip OA
• From trochanteric bursitis: direct palpation of bursa • From hip OA: if reaching down to tie shoes aggravates pain, likely OA
54
for a **gluteus medius tendinopathy/tear** what is a excellent reliability for full thickness rear
diagnostic ultrasound
55
what is the big warning about a gluteus medius tendinopathy/tear diagnosis
needs to be localized pain that is load dependent **diffuse pain w low load i NOT tendinosis**
56
what do u do during the stages for gluteus medius tendinopathy/tear stage 1 stage 2 stage 2.5 stage 3 stage 4
1: isometrics 2: isotonic strength 2.5: functional strength and endurance 3: energy storage 4: sports elastic
57
the CPG’s for diagnosing non arthritis hip issues says what
clinicians should use the clinical finding of anterior groin or lateral hip pian or generalized hip joint pain that is REPRODUCED with FADIR or FABER test
58
what is highly correlated with labral pathologies
hip OA
59
who is **acetabular labral** pathologies common in
**highly active** individuals 20-40 y/o
60
what is excessive contact between femoral head-neck junction and acetabular rim
femoroacetabular impingement (FAI0
61
what are the 2 types of FAI
cam impingement and pincer impingement
62
what is the cam impingement and pincer impingement related to
cam: related to femorla head/neck pincer: related to acetabular morphology
63
what FAI impingement is seen often with patients with h/o SCFE or Legg-Calve-Perthes, or present with femoral head anteversion, coxa vara
cam
64
what kind of **acetabular abnormaliaites** is **pincer impingement** related to
acetabular retroversion coxa profunda acetabular protrusions
65
if a patient has a FAI and they have anterio medial hip region pain what is the positioning
see w flexion/ IR passive positioning
66
if a patient has a FAI and they have posterior hip region pain what is the positioning
flexion /abd / ER
67
femorla neck stress fx are seen in what pt population
marathoner (someone who is highly active)

MSK: LQ (22 decks)

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