Other Hip Path

Question 1

Greater trochanteric bursitis

Answer 1

common issue 
common type of bursitis about the hip
FEMALES 
MIDDLE AGED TO ELDERLY PATIENTS 
ISOLATION OR ASSOCIATED WITH OTHER CONDITIONS

Question 2

assoc. conditions of greater trochanteric bursitis

Answer 2

lumber spine disorders, hip conditions, leg length discrepancy, RA, previous surgery about the hip, and ipsilateral quad weakness and knee conditions

RUNNING CAN LEAD TO FRICTION ALONG THE IT BAND**MOST TYPICAL

Question 3

Presentation of trochanteric bursitis

Answer 3

pain and tenderness over the greater trochanter - may radiate to the lateral thigh
CANT SLEEP ON THE SIDE OF THE BURSITIS
INTERNALLY ROTATED
ADDUCTED

Question 4

Tx of GT bursitis

Answer 4

activity modifications
NSAIDs
injection of the bursa with corticosteroids

Question 5

Injections

Answer 5

Usually intra-articular injections are done in the OR

An office injection of corticosteroids indicate that the pt probably has a hx of GT bursitis that was treated

Question 6

Snapping of the Hip

Answer 6

External and Internal snapping

Question 7

External snapping of the hip

Answer 7

Lateral

Snapping is by the IT band over the greater trochanter

Question 8

Internal snapping of the hip

Answer 8

Medial

snapping is the iliopsoas over the iliopectineal eminence

Question 9

Dx external snapping hip

Answer 9

snapping and pain are on the lateral side

FEMALES RUNNING ON BANKED SURFACES - CROSS COUNTRY RUNNERS

Question 10

Climbing stairs or rising from a seated position- Dx

Answer 10

External snapping of the hip

Question 11

Test External snapping of the hip

Answer 11

reproduce the pain by passively flexing the its hip from an adducted position

=adduction tightens the IT and flexion drags it across the trochanter to reproduce the snapping noise

Question 12

Dx of internal snapping of the hip

Answer 12

Pain is in the groin

subluxation over the iliopectineal eminence
reproduce this by flexion to extension

=iliopsoas stretches out in extension and snaps over the iliopectineal eminence

Question 13

Meralgia Paresthetica

Answer 13

Not common

entrapment of the lateral femoral cutaneous nerve under the ASIS, inguinal ligament and sartorius m.

Question 14

MOI of MP

Answer 14

obesity**
direct compression by tight clothing **
scarring
repetitive trauma over the nerve

Question 15

Sx of MP

Answer 15

pain and dysesthesia that radiate to the lateral aspect of the thigh
NOT THE HIP OR KNEE WHICH ARE OBTURATOR N.

Question 16

PE of MP

Answer 16

Postitive Tinel’s sign over the ASIS
decreased sensation in the distribution of the lateral femoral cutaneous n. (lateral thigh)
Provacative test with local anesthetic at ASIS = relieves the Sx

Question 17

Tx of MP

Answer 17

Avoidance of clothes or activities
weight reduction***
injection of corticosteroid