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comeback szn > MS1: Affectations of Hip > Flashcards

MS1: Affectations of Hip Flashcards

1
Q

the largest and most constant bursa of hip

A

iliopsoas bursa

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2
Q

what are the 2 types of trochanteric bursa

A

subgluteus med and subglutes max

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3
Q

what is ischiogluteal bursa

A

aka weavers bottom; in sitting

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4
Q

discuss the etiology of osteonecrosis of FH

A

trauma - mga fractures, disloc basta pag impair sa blood supply

impairment of circulation - mga diabetes, sickle celll, gaucher’s
- prolonged steroid use

idiopathic - LCPV

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5
Q

discuss the pathology of osteonecrosis of Fh

A

total or incomplete

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6
Q

what are the stages of osteonec of FH

A
  1. degeneration and disapperance ng osteocytes - hyperemia or new blood vessels from around the bone na necrotic
  2. revascularization - invasion of new bv and ct on infarc area
    - osteoclastic resorption tas replace new bone
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7
Q

what is crescent sign

A

result ng subchondral fracture bc of the osteoclastic activity sa onstenecro ng FH

bc weak so mag collapse yung head or flatten

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8
Q

clinical features of osteonecro of FH

A

pain on hip; if children referred to knee

limited abd and IR

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9
Q

treatment of osteonecro of FH

A

children - abduction brace

adults - surgery

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10
Q

what is LCPD

A

idiopathic osteonecrosis sa children

aka coxa plana

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11
Q

occurence of LCPD

A

mga below 7 yo

more in boys and mas madalas unilat

YOUNG THIN SHORT BOYS

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12
Q

pathology of LCPD

A

80% can recover - self limited for 2-3 yrs

necrosis of epiphysis kaya mag llead to growth disturbance - short femur

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13
Q

clinical features of LCPD

A

LIMP - most constant

pain referred in knee

limited abd and IR

may lead to OA

FABER

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14
Q

what are the stages of LCPD

A

caterall staging

group 1 - only anterior head; BEST PROGNOSIS

2 - 1/2 and collapsed na yung gitna

3 - most of head

4 - total head

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15
Q

what are indication of poorer prognosis is LCPD

A

caterall 3 or 4 - diffuses metaphyseal resorption

defect in epiphysis - gage’s sign

calcification

lat subluxation

GIRLS

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16
Q

how is transient synovitis DD from LCPD

A

movement produces pain

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17
Q

how is juvenile RA DD from LCPD

A

pain in diff parts of body like fingers

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18
Q

discuss good prognosis of LCPD

A

caterall 1

younger and slender children - dont put too much weight

BOYS

FH is contained well in acetabulum

  • above 30 may lead to OA
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19
Q

treatment of LCPD

A

traction in early stages - to relieve spasms

abduction brace - abd and IR; walking with brace

surgical - older than 6, caterall 3 or 4

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20
Q

which is more common congenital coxa vara or valga

A

VARA

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21
Q

describe congenital coxa vara

A

developmental or infantile; not detected at birth sa pag grow

lesser angle ng neck - TOWARDS 90 deg

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22
Q

clinical features of congenital coxa vara

A

painless waddling gait - + trendelenburg

limited abd and IR; inc add and ER

prominent greater trochanter

shorter leg

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23
Q

desrcibe coxa valga

A

towards 180 deg - greater than 135 angle

bc children unable so stand - paralytic mga polio, CP

can lead to OA

longer leg

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24
Q

discuss the occurrence of slipped capital femoral epiphysis

A

adolescent OBESE BOYS

earlier in girsl ng 2 yrs kase puberty

mostly uni; 25% bilat

bc of trauma or strain

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24
etiology and pathology of SCFE
idiopathic rapid growth, oblique physis and minor trauma mga trip or fall ganun head slips down
25
what are the types of SCFE
acute - severe trauma; least common acute superimposed on chronic - mild pain or dicommfort followed by mild trauma chronic - gradual; weak to months - limp
26
clinical features of SFCE
affected limb becomes shorter and smaller limited abd and IR finds comfort in obligatory ER; when walking - flex add ER
27
discuss the degrees of slippage in SFCE
minimal - widening of physis or less than 1/3 moderate - 1/3 to 1/2 severe - more than 1/2
28
discuss diagnosis of SFCE
pain is referred to knee or medial thigh thats why need xray to confirm
29
discuss treatment of SFCE
acute na less than 2 wks - manipulation and pinning; traction more than 3 wks - no manipulation kase ma disrupt vessels = osteonecro mild to moderate - pinning severe - surgery LOSE WEIGHT
30
clinical features of iliopec/psoas bursitis
tenderness on ant hip s inguinal lig relieve by flex, abd and er pain by ext, add and ir
31
dd for iliopec/psoas bursitis
femoral hernia - nawawala bukol psoas abcess - back arthritis
32
treatment for iliopec/psoas bursitis
bed rest tas traction - gentle rom
33
clinical features of deep trochanteric bursitis
LE held in abd in ER to relax glut max bursa tender behind greater trochanter pain radiate to back thigh
34
clinical features of superficial trochanteric bursitis
pain in extreme add
35
discuss ischiogluteal bursa
tender over sit bone tas pain radiates s post thigh pillow or sit cushion
36
what is congenital hip dysplasia
can be DDH - developmental bc sublaxation from shallow acetabulum or deformed head always w other congenital diseases
37
most common hip disorder in children
congenital hip dysplasia
38
discuss the occurence for CHD
0.1 % born w dislocated hip 1% hip sublaxation - mas common 80% female children more common on left hip 60% multifactorial
39
clinical features of CHD
less than 6 mo. - LOM and limb shortening; more lines = shorter toddlers - restricted motion, limp and waddling gait adolescent - fatigue and pain in hip, thigh, knee dec abd so also do FABER; ROM normal if infant bx no contractures pa
39
risk factors of CHD
female and if firstborn packaging problems - premature acetabulum - congenital disloc of knee, torticollis - family history
40
discuss barlow and ortolani
for CHD barlow - dislocation ortolani - relocation
41
what is galeazzi test
for CHD UNILATERAL ONLY pag mas mababa isa edi yun yung involved - positive
42
management of DDH
0-6 mo tas dysplastic - pavlik harness 6-18 or older 18 tas dislocated - surgery
43
classifications of hip dislocation
anterior - trauma while flex, abd, ER posterior - flex, add, IR; MOST COMMON central disloc - pumasok yung femoral head; basag acetabulum
44
discuss hip pointer
direct trauma to iliac crest pain and tenderness; ambulation and abd
45
discuss IT band syndrome
lateral thigh, hip or knee pain + ober's
46
snapping hip
extra - tight sila - IT band over greater trochanter - iliopsoas sa iliopectineal eminence intra - labral tear
47
most common n snapping hip
IT BAND
48
PE of snapping hip
IT - sa greater trochanter during flex-ext, add tas IR iliopsoas - sa groin during ext-flex, abd tas ER
49
causes of acetabular fracture
MVA fall from height tas naka stand direct impact sa greater trochanter indirect - dashboard
50
complications of acetabular fracture
sciatic nerve palsy - MOST COMMON sup gluteal artery or vein injury ossification avascular necro chondrolysis arthritis
51
etiology of pelvic fracture
MVA or fall from height avulsion fracture - bc of pull ng muscles; ischium - hamstring osteoporosis - pubic rami
52
kinds of pelvic fracture
anteroposterior - dapa tas nagulungan - open book pelvis lateral - one side of pelvis vertical - jump
53
classes of pelvic fracture
A- stable; sa iliac crest lng ganun B - vertical stable; rot unstable C - vertical and rot unstable
54
comlications of plevic fracture
hemorrhage lumboscaral plexus injury bladder and urethra injurt DVT to lungs kaya high mortality rate
55
clinical features of pelvic fracture
pain over pelvis flank or buttocks contusion leg lenthg discrep pag avulsion pain worse in contracting muscle
56
treatment of pelvic fracture
conservative - type a or b surgery - type c
57
etiology of femoral head fracture
occus w hip disloc from trauma or fatigue - osteopenic or subchondral impaction
58
what are complications ans ssx of FHF
avascular necrosis and arthritis pain and deformity ng head
59
conservative treatment of FHF
conservative - pag acute and dapat ma reduce within 6 hrs - weight bearing 4-6 eks - no add and IR surgery pag pipikin 2 - 4 or dislocated tas old
60
discuss femoral neck fracture
common in osteoporotic elderly sa ward's - fall pwd din sa young pag major fall or trauma
61
complications of FNF
avascular necrosis infection DVT and embolism - kaya high mortality s 1st yr
62
SSx of FNF
pain involved is shorter limp or cant ambulate tenderness sa greater trochanter
63
discuss intertrochanteric fracture
usually sa mas old tas mild fall lng pwede young pero MVA or high energy trauma
64
complication ng intertrochanteric fracture
varus collapse wound infect non union RARE avascular necro RARE mortality s 1st yr 30%
65
discuss PE of foot in intertrochanteric and subcapital fractures
shorter leg kase na ppull ng rectus, adductors tas hamstring lat rot kase pull ng glut max, piriformis and gemeli
66
what is arthroplasty
surgery to relief pain and restore motion tas early ambulate sa mga arthritis, fracture and avascular necro SA OLD LANG WAG YOUNG
67
pre-requesites ng arthroplasty
WAG NA PAG TUBERCOLOSUS need dapat controlled ng 1 yr yung infection bago mag opera well motivated patieny healthy muscles and joint
68
what are the 2 types nf arthroplasty
total - papalitan acetabulum at head partial - head lanf
69
discuss hemiarthroplasty
unipolar - pag less active and old na kase pwede mag erode bipolar - replace head and neck tas acetabulum
70
discuss the types of fixation in arthroplasty
cemented - for old para makalakad agad; less active dapat cementless - bine grow into prosthesis; pag YOUNG
71
INDICATION NG ARTHROPLASTY para di madislocate
no flexion BEYOND 90 no abd BEYONG 45 no add BEYOND midline no ROTATION
72
complications of arthroplasty
dislocation fracture sciatic impinge

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