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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
Q

what is the ROM and gait fro someone with avascular necrosis

A

decreased ROM
limp gait

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26
Q

what is the intervention for avascular necrosis

A

protected WB
PT exercise is to maximize soft tissue function

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27
Q

what is the age and gender the DJD is most common in

A

> 40 y/o
females

28
Q

how is the onset for dJd and when is there pain

A

insidious onset
pain with WB

29
Q

what is the observation , ROM and gait from DJD

A

observation: often fat , joint crepitus; muscle atrophy of gluteal muscles
• ROM: limited, capsular pattern
• Gait: limp

30
Q

what is the intervention for someone with DJD

A

NSAIDS
Manual therapy
sx last resort

31
Q

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

A

DJD

32
Q

what is Altman’s Clinical Criteria for Hip OA (5)

A
  • Hip pain
  • IR <15 degrees
  • Pain with IR
  • Morning stiffness up to 60 minutes
  • Age >50 y/o
33
Q

what is Sutlive CPR for Presence of Hip OA (5)

A

• 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
Q

what are the 4 things that are ranked “A” for CPG’s for hip pain and mobility deficits - hip OA

A

-risk factors
-diagnosis/classification
- examination; outcome measures
-examination ; activity limitation and participation restriction measures

35
Q

what is patient educations grade for CPG’s for hip pain and mobility deficits - hip OA

A

B

36
Q

what is manual therapy for CPG’s for hip pain and mobility deficits - hip OA

A

B

37
Q

what is flexibiltiy , strengthening, and endurance exercises graded for CPG’s for hip pain and mobility deficits - hip OA

A

B

38
Q

what is pathoanatomical features for CPG’s for hip pain and mobility deficits - hip OA

A

B

39
Q

what is functional gait and balance training graded for CPG’s for hip pain and mobility deficits - hip OA

A

C

40
Q

what physcial examination measures may be helpful int he differential diagnosis process when differentiation hip pain from other sources of pain ? (6)

A
  • scour test
    FABER
    -fitzgerald test
  • FADIR
    -SIJ provocation test
  • femoral nerve stretch
41
Q

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
A

in OP

42
Q

for a THA pt when do u consider these things

• Prevent DVTs
• Initiate HEP/gait training/transfers
• THR precautions
• Home equipment recommendations

A

acute care

43
Q

what mm’s are likely to have a mm strain

A

hammy
RF
adductor longus

44
Q

ITB syndrome what is ..

  • onset:
    -S&S:
    -special test:
A
  • onset : gradual
    -S&S: laterla hip ,thigh or knee pian
    snapping IT band over GT

-special test: obers

45
Q

where is there pain for a trochanteric burtitis

A

pain over GT w resisted abduction
pain on palpation of GT

46
Q

what is the treatment for ITB syndrome

A
  • Modification of activity
  • Footwear
  • Stretching & strengthening exercises
  • NSAIDs
47
Q

what is the treatment for trochanteric bursitis

A
  • Ice
  • NSAIDs
  • IT band stretching
  • Protection from direct trauma
  • Steroid injection
48
Q

for myositis ossificans what is..

HX:
S&S:
imaging:

A
  • Hx: direct trauma; contusion w/
    hematoma 2-4 weeks prior
  • S&S: pain on palpation &
    motions; ecchymosis
  • Imaging: X-ray or US
49
Q

what is the treatment from myositis ossifcans

A
  • Ice
  • NSAIDs
  • Stretching
  • If PT fails → orthopedic surgery
50
Q

for meralgia parasthesia what is …

HX:
S&S:
where do they have abd normal sensory examination over

A
  • 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
Q

what should u avoid during treatment and what is appropriate from meralgia parasthesia

A

avoid external compression of nerves

nerve glides as appropriate

52
Q

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

A

gluteus medius tendinopathy/tear

53
Q

what is the main difference between gluteal medius tendinopathy/teat from a trochanteric bursitis and from hip OA

A

• From trochanteric bursitis: direct palpation of
bursa
• From hip OA: if reaching down to tie shoes
aggravates pain, likely OA

54
Q

for a gluteus medius tendinopathy/tear what is a excellent reliability for full thickness rear

A

diagnostic ultrasound

55
Q

what is the big warning about a gluteus medius tendinopathy/tear diagnosis

A

needs to be localized pain that is load dependent

diffuse pain w low load i NOT tendinosis

56
Q

what do u do during the stages for gluteus medius tendinopathy/tear

stage 1
stage 2
stage 2.5
stage 3
stage 4

A

1: isometrics
2: isotonic strength
2.5: functional strength and endurance
3: energy storage
4: sports elastic

57
Q

the CPG’s for diagnosing non arthritis hip issues says what

A

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
Q

what is highly correlated with labral pathologies

A

hip OA

59
Q

who is acetabular labral pathologies common in

A

highly active individuals 20-40 y/o

60
Q

what is excessive contact between femoral head-neck junction and acetabular rim

A

femoroacetabular impingement (FAI0

61
Q

what are the 2 types of FAI

A

cam impingement and pincer impingement

62
Q

what is the cam impingement and pincer impingement related to

A

cam: related to femorla head/neck

pincer: related to acetabular morphology

63
Q

what FAI impingement is seen often with patients with h/o SCFE or Legg-Calve-Perthes, or present with
femoral head anteversion, coxa vara

A

cam

64
Q

what kind of acetabular abnormaliaites is pincer impingement related to

A

acetabular retroversion
coxa profunda
acetabular protrusions

65
Q

if a patient has a FAI and they have anterio medial hip region pain what is the positioning

A

see w flexion/ IR passive positioning

66
Q

if a patient has a FAI and they have posterior hip region pain what is the positioning

A

flexion /abd / ER

67
Q

femorla neck stress fx are seen in what pt population

A

marathoner (someone who is highly active)

MSK: LQ (22 decks)

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