orthopedics

Question 1

why does hip pathology produce pain in the groin which may radiate to the knee?

Answer 1

due to the obturator nerve supplying both joints and referred pain

Question 2

what gives rise to buttock pain?

Answer 2

hip pathology however lumbar spine and SI joint problems can also give rise to buttock pain

Question 3

what hip pathology purely presents with knee pain?

Answer 3

SUFE (particularly)

Question 4

what is the first sign noted in the examination?

Answer 4

loss of internal rotation and reduced range of motion

pain may be exacerbated by rotational movements

Question 5

what causes a positive trendellenburg sign or gait?

Answer 5

altered hip biomechanics or weakness from chronic dies, abductor weakness (gluteus medium and minimum)

Question 6

what is seen in severe OA, Perthes, SUFE or AVN (or fracture)?

Answer 6

shortening of the lower limb

Question 7

what can also cause groin pain?

Answer 7

hernie (inguinal or femoral), tendonitis (especially adductor tendonitis), pubic symphysis dysfunction or high lumbar disc prolapse (with L1/2 radiculopathy but this is very rare)

Question 8

what is the role of the menisci?

Answer 8

important as shock absorbers and act to distribute the load evenly

Question 9

what is the principle role of the ACL?

Answer 9

prevent abnormal internal rotation of the tibia

Question 10

what is the role of the PCL?

Answer 10

prevents hyperextension and anterior translation of the femur

Question 11

what is the role of the MCL and LCL?

Answer 11

MCL resists valgus force whilst the LCL resists various force and abnormal external rotation of the tibia