MSK basic - hip conditions Flashcards
Intra-articular conditions
o Femoral acetabular impingement (FAIS)
o Dysplasia
o Mircoinstablity
o OA
o Stress fracture
o Labral tear
Extra articular issues
o Great trochanteric syndrome
o Iliopsoas related groin pain
o Adductor injuries
o Athletic pubalgia/ core injuries
o Piriformis syndrome
o Pubic related groin pain
Femoral acetabular impingement (FAIS) - symptom location
groin - C sign
Femoral acetabular impingement (FAIS) - activity aggravations
Prolonged flexion and or IR
FAIS - what population
younger pop
Female > male
FAIS strength deficits
Abductor muscles
Hip rotators
FAIS - testing (special tests)
FADIR
FAIS - functional test
Step down
Single leg squat
- May provoke primary symptom
- Poor frontal and transverse place control
- Poor pelvic and postural control
Mircoinstablity - pain location
Groin
Pelvic muscle-tendon pain
Mircoinstablity - aggrevations
repetitive forces to the iliofemoral ligament and labrum
Mircoinstablity - strength
Abductors
Rotators
Lumbopelvic
Mircoinstablity - population
Beighton – universal laxity may predispose
Younger population
Mircoinstablity - tests
Log roll
Prone apprehension test
ROM – excessive or apprehensive
mircoinstablity - Functional
- Poor frontal and transverse place control
- Poor pelvic and postural control in the frontal plane
Labral tear - presentation
Anterior hip/groin pain
painful clicking and poping
Labral tear - what kind of injury
Overuse injury
Labral tear - normal strength
No issues with pain or strength or flexibility testing
Labral tear - testing
FADIR - Flexion and IR
Rebound pain with LAHD
Loss of ROM
what kind of treatment is first used with a labral tear
conservative
OA - location
anterior (groin)
and/or
lateral regions of the hip
OA - presentation
joint crepitus
(Gradual on set)
Stiffness greater in the morning: decreasing in 1hr.
OA - pop
45 or older
History of development disorder
FAI history
Previous injury to hip
OA tests
FABER
Scour
(-) FADIR
Range of motion in a capsular pattern (IR > abd > flexion)
Long axis distraction
Hip Stress fracture - pain location
Groin & anterior thigh most common
hip stress fraction - presentation
- after strenuous activity
- Low level activity
- (acute) painful at night and with rest
hip stress fracture - tests
end-range IR overpressure
SLR
MMT flexion
MMT abduction
Clinical Tests: Patellar-pubic Percussion Test
Greater trochanteric pain syndrome (GTPS) - pain loction
Lateral hip region
- Worst pain over the greater trochanter
- May radiate around the trochanter
Greater trochanteric pain syndrome (GTPS) - presentation
snapping symptoms
Variable:
Walking
side lying
sitting
Fatigue and possible gait disturbance
May demonstrate difficulty on stairs
Greater trochanteric pain syndrome (GTPS) - test
Test/results:
Palpation- tendon pain
Resisted - Pain/weakness with resisted abduction
Gluteal Derotation Test - +
Single leg stand – pain w/in 30 secs (change to SL-squat for athletes)
*Rule out intra-articular involvement as primary source
*the more of these finding the more we think this is the issue
what is GTPS
when the tissue that lie outside of the hip bone become
