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FALL2 MSK > LECTURE 5B HIP JOINT EXAM > Flashcards

LECTURE 5B HIP JOINT EXAM Flashcards

1
Q

does age matter in the hip?

A

YES (dysplasia when young= issues forever)

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2
Q

common hip pathologies for newborn

A

congenital dislocation of hip

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3
Q

common hip pathologies for 2-8 year olds

A

AVN (legg Perthes)
*can get open growth plates if offloaded with brace

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4
Q

common common hip pathologies of children

A

hemophilia
*blood clotting disorder
*blood can leak into hip joint, leading to effusion/inflammation

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5
Q

common hip pathologies for 10-14 year olds

A

slipped epiphysis (SCFE) osteochondritis dissecans (OCD)

*obese young boys

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6
Q

common hip pathologies for 14-25 year olds

A

stress fx, synovitis, FAI

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7
Q

common hip pathologies of young adults

A

muscle lesion, bursitis, synovitis, FAI

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8
Q

common hip pathologies of 45-60 year olds

A

OA, synovitis

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9
Q

common hip pathologies of female 50+

A

Gluteus medius tendinopathy/tears

SUPER TRENDELENBURG

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10
Q

common hip pathologies of older adults

A

stress fx, OA, fx & post-replacement

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11
Q

common hip pathologies of 65+

A

stress fx, OA

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12
Q

congenital hip dislocation causes limited

A

ABDUCTION

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13
Q

If someone has a breech birth, what could happen?

A

congenital hip dislocation
BIRTH

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14
Q

incidence for congenital hip dislocation

A

females more than males
Left more than right

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15
Q

If someone comes in with a short limb, hip flexed, abduction…

A

congenital hip dislocation

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16
Q

what two tests are for congenital hip dislocation?

A

galeazzi’s sign or ortolani’s sign
(displaces UP and LATERALLY (acetabulum delayed development)

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17
Q

If someone is -___years old
male> female
gradual onset of hip ache/thigh/knee, what do they have?

A

age: 2-13 years
Legg-Calve-Perthes

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18
Q

Legg Calve Perthes ROM deficits

A

Observation: short limb, higher greater trochanter, quad atrophy, adductor spasm
ROM: limited abd & ext
Gait: Antalgic after activity

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19
Q

short limb, teenage males
usually obese
quad atrophy
adductor spasm
hip abduction, ER

A

SCFE

20
Q

What ROM is limited in SCFE?

A

limited in IR, abd, flex

21
Q

-Age: 30-50 y/o
-Incidence: Male > Female
-50% w/ sharp pain & 50% intermittent in extreme motion
-ROM: decreased
-Gait: limp

A

AVASCULAR NECROSIS

22
Q

intervention for avascular necrosis

A

protected WB
exercise
surgery if PT doesnt work

23
Q

Age: > 40 y/o
Incidence: Female > Male
Insidious onset, pain w/ weight bearing
Observation: often obese; joint crepitus; muscle atrophy of gluteal muscles
ROM: limited, capsular pattern
Gait: limp

A

DJD

24
Q

ALTMAN’S clinical criteria for hip OA

A
  1. hip pain
  2. IR less than 15
  3. pain with IR
  4. morning stiffness up to 60 min
  5. older than 50 years old
25
Q

If someone 50+ shows up with hip pain, decreased IR, morning stiffness….

A

OA OR DEGENERATIVE

26
Q

Sutlive CPR for hip OA

A
  1. pain with squat
  2. Scour Test with adduction causes groin or lateral hip pain
  3. Active hip flexion causes lateral pain
  4. Active hip extension causing hip pain
  5. Passive hip IR less than or equal to 25 degrees

*3/5 positive =68%
*4/5 positive =91%

27
Q

CPG for hip!

A

A: risk factors considered
A: diagnosis/classification
A: exam with outcome measures
A: exam with activity limitation/participation restriction measures

B: patient education, manual therapy

C: Functional gait, balance training (important, but not first tx)

E: diff dx

28
Q

hip OA ruling in…

A

Age and capsular pattern for ruling in

29
Q

Diff Dx tests for ruling OUT hip OA

A

scour test-labral
FABER-labral
Fitzgerald-labral
FADIR-labral
SI stress-SIJ
femoral nerve stretch test-L2-3 radiculopathy

30
Q

acute care treatment for total hip arthroplasty

A
  1. get up and moving
    PREVENT DVTs (HEP/gait/transfers)
    *home equipment recommendations

PRECAUTIONS!!!!

31
Q

OP care for THA

A

-Progressive strengthening
-Mobilization (gentle) into limited ranges (***extension)
Soft tissue and neural mobility
Advanced gait activities with/without AD
BALANCE training

32
Q

most common muscle for myositis ossificans

A

quad muscle
COMMON WITH TRAUMA (3wk post injury)
*watch for decreasing ROM, increasing pain

33
Q

common mm strains

A

hamstrings
rec fem (mid/upper 1/3)
adductor longus

34
Q

post pelvis sx or pregnancy common injuries

A

osteitis pubis
or symphysiolysis

35
Q

lateral hip, thigh or knee pain; snapping IT band over greater trochanter

A

ITB syndrome due to OVERUSE
*ober’s test

36
Q

Pain over greater trochanter; with resisted abduction
Pain on palpation of greater trochanter
*overuse OR direct trauma

A

trochanteric bursitis

37
Q

treatment for bursitis

A

Ice
NSAIDs
IT band stretching
Protection from direct trauma
Steroid injection (only 3x/year)

38
Q

treatment for ITB syndrome

A

Modification of activity
Footwear
Stretching & strengthening exercises
NSAIDs

39
Q

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

A

myositis ossificans

40
Q

Hx: gradual onset, often obese & pregnant women
S&S: pain or paresthesia of anterior or lateral groin & thigh
Abnormal sensory examination over distribution of lateral femoral cutaneous nerve

A

Meralgia paresthesia

41
Q

treatment for myositis ossificans

A

ice, NSAIDs, stretching
if PT fails-> SX

42
Q

treatment for meralgia paresthesia

A

Avoid external compression of nerve
Nerve glides as appropriate

43
Q

Both pain when palpated,
diffuse pain with LOAD is probably…(glute med tear or bursa?)

A

glute med tear

44
Q

SLIDE 20

A
45
Q

cam impingement

A

femoral neck/head has excess bone

46
Q

pincer impingement

A

acetabulum has excess bone

FALL2 MSK (18 decks)

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