Lower Quarter - Screening Flashcards
What past medical history factors are important for lower quadrant screening?
Cancer (e.g., prostate, breast), joint replacement, history of alcoholism (osteonecrosis).
What are common risk factors for lower quadrant pain?
Varies by system; includes infection, atherosclerosis, and improper implant size.
What are typical pain patterns for neuromusculoskeletal hip pain?
Hip pain can refer to low back, buttock, groin, SI joint, anterior thigh, or even knee or ankle.
What is the typical presentation of hip pain from the upper lumbar vertebrae?
Pain radiates into the anterior aspect of the thigh.
What is the typical presentation of hip pain from the lower lumbar vertebrae?
Pain felt in the gluteal region with radiation down the back or outer aspect of the thigh.
What test is highly specific for intraarticular hip pain?
Log rolling test (high specificity).
What is a common cause of unilateral or bilateral groin pain after activity?
Adductor strain.
What are the signs of a sports hernia (athletic pubalgia)?
Deep groin pain aggravated by activity, often involving tear of adductors, lower abdomen, and fascia.
What are the characteristics of a labral tear?
Night pain, positive FADIR test (high specificity), and common in asymptomatic populations.
What are signs of femoroacetabular impingement (FAI)?
Younger adults, gradual onset, pain with walking, sitting, or sports, rule in/out with log roll test or FABER.
What are systemic causes of groin pain?
Cancer, gynecological conditions, prostate/testicular pathologies, infection.
What signs suggest a systemic cause of anterior thigh pain?
Look for urologic problems, lower thoracic disc herniation, tumor, or abscess.
What does posterior or posterolateral thigh pain indicate?
Lower lumbar vertebrae or sacrum involvement.
What does lateral thigh pain suggest?
Inflammation of TFL and ITB syndrome, or T-L junction dysfunction.
What is a common cause of anterior thigh pain in older patients?
L3-L4 disc herniation, especially in those with a history of lumbar spine surgery.
What are typical signs of mechanical knee pain?
Local pain and tenderness, locking, giving way, or poor localization with weight-bearing.
What are systemic causes of generalized knee pain?
Fractures, Baker’s cyst, tumors, arthritis, infection, DVT.
What differentiates vascular claudication from neurogenic claudication?
Vascular: bilateral, no burning; Neurogenic: burning in back, buttocks, or legs.
What are common signs of peripheral neuropathy?
Pain, aching, numbness, motor, sensory, autonomic changes, stocking-glove pattern.
What are typical symptoms of restless leg syndrome?
Crawling sensation in legs, involuntary calf contractions at night, sleep disturbance.
What are the two types of stress fractures?
Insufficiency fracture (normal forces on abnormal bone), fatigue fracture (abnormal forces on normal bone).
What test is highly sensitive for stress fractures?
Fulcrum test (Sn = 1.0).
What are risk factors for systemic causes of sciatica?
General: age, comorbidities, cancer; Arterial: smoking, atherosclerosis; Infectious: surgery.
What are red flags for oncologic causes of lower quadrant pain?
Painless lymph node enlargement, fever, weight loss, bleeding, skin lesions.
What are signs of an osteoid osteoma?
Hip, thigh, or knee pain worse at night, antalgic gait, relieved by aspirin.
What are signs of urologic causes of groin pain?
Pain in upper thigh or groin with ureteral pain, positive Murphy’s percussion test.
What are signs of prostate or testicular pathologies?
Groin pain with LBP/buttock/pelvic pain; may be caused by prostate or testicular cancer, BPH, prostatitis.
What are signs of a psoas abscess?
Constitutional symptoms, hip pain in medial thigh or femoral triangle, hip flexion and IR, positive iliopsoas test.
What signs suggest gastrointestinal causes of lower quadrant pain?
Alternating abdominal and back or hip pain, symptoms not relieved by PT, psoas abscess.
What signs suggest vascular causes of lower quadrant pain?
Throbbing pain with activity, trophic changes, abnormal vital signs, risk factors like tobacco use, heart disease.
What sign indicates appendicitis related to thigh pain?
Positive reverse straight leg raise (SLR) test.
What systemic signs are associated with osteonecrosis?
Diabetes, long-term corticosteroid use, Cushing’s syndrome, alcohol abuse.
What red flag is associated with Hodgkin’s disease?
Painless enlargement of inguinal or popliteal lymph nodes.
What is a common presentation of Crohn’s disease?
Back or joint pain occurs in 25% of patients, skin rash may precede joint pain.
What are red flags for avascular necrosis?
Hip pain, difficulty weight-bearing, antalgic gait, limited ROM (especially flexion, abduction, IR).
What test is positive for a psoas abscess?
Positive iliopsoas test or obturator sign.
What signs suggest a systemic cause of back pain?
Constitutional symptoms, failure to improve with PT, associated signs like fever or weight loss.
What symptom is common in older adults related to vascular issues?
Burning or pain in the legs and feet at night.
What clinical presentation is typical for gastrointestinal causes of hip pain?
Hip pain with associated bowel symptoms like Crohn’s disease or irritable bowel syndrome.
What does a positive Murphy’s percussion test indicate?
Urologic cause, often related to kidney involvement.
