Pelvis and Hip 2 Flashcards
where is the position of the hip socket where impingement normally occurs?
12 to 2 o clock position - anterior / superior position
what muscle stabilizes the hip during hip motion and weightbearing?
gluteus medius
where do the adductor muscle originate?
pubis
t/f there is a clinical association between FAI and athletic pubalgia
true
which fascial structure is at the core of understanding athletic pubalgia?
pubic aponeurosis
describe the attachments of the direct and indirect head of the rectus femoris at the hip
direct - originates at the AIIS
indirect - broad attachment to the acetabular rim
where does the piriformis originate?
anterior surface of the sacrum
the blood supply of the femoral head is largely supplied by what artery?
deep branch of the medial femoral circumflex artery
what nerve root supplies most of the innervation to the hip
L3
what is the reason that hip pathology can be referred to the medial leg?
hip and medial leg are both supplied by the L3 dermatome
describe the relative course of the lateral femoral cutaneous nerve relative to the inguinal ligament
exits the pelvis UNDER the inguinal ligament
what bony structure separates the greater and lesser sciatic notch?
ischial spine
in an avulsion injury of the proximal hamstrings, what degree of retraction should prompt surgical referral within 6 weeks of injury?
3cm or more retraction of the tendon
for an avulsion injury of the proximal hamstring with less than 3 cm retraction , non operative treatment with what injection can be offered initially?
PRP
what is the treatment for the vast majority of rectus femoris injuries?
conservative management
what ligament attaches the femoral head to the acetabulum?
ligamentum teres
what is the treatment for gluteus tendon avulsion?
early surgical repair
what are the three subtypes of FAI?
CAM, pincer and mixed
when does the external iliac artery become the femoral artery?
after crossing underneath the inguinal ligament
which condition causes misshapen femoral head, shallow acetabulum, excessive anteversion of the acetabulum and proximal femur?
DDH
what is the ultimate treatment for FAI?
surgery (including labral repair component)
describe the center edge angle of Wiberg on a radiograph when assessing hip dysplasia?
vertical line drawn from the center of the femoral head and a line from the center of the femoral head to the lateral edge of the acetabulum
what center edge angle of Wiberg measurement is considered dysplastic?
20 degrees or less
describe the relative difference in pain sitting/standing between FAI and DDH, which can help to differentiate these conditions
DDH - more pain with standing
FAI - more pain with sitting
dysplasia of the hip joint could be in either or both of what two directions?
lateral and anterior
t/f in a case of DDH, in patients with degenerative cartilage, surgery to preserve the hip joint is contraindicated
true
ischiogluteal bursitis is inflammation in the bursa found between what two structures?
gluteus maximus and ischial tuberosity
how would you differentiate ischial bursitis from hamstring injury on physical exam?
absence of pain with stretching - indicative of bursitis
80% of acute hamstring injuries occur in what muscle?
long head biceps femoris
for how long minimum should you allow for recovery for a grade 1 / 2 hamstring injury?
4 weeks
what are the three main osseous areas of the hip where avulsion can occur in athletes?
AIIS (rectus) , ASIS (sartorius) and ischial tuberosity (hamstring)
the insertion of what two adductor muscles can be related to medial femoral shaft stress fractures?
adductor longus and brevis
a patient is found to have osteoid osteoma of the femur. what is the typical treatment?
radiofrequency ablation
what type of fracture is associated with chronic bisphosphonate use?
atypical femur fracture
what percentage of cases of atypical femur fracture have bilateral occurrence?
50%
a patient with known breast cancer has a positive halo sign (bright) on T2 weighted images of the hip. what is the most likely cause of this radiographic finding?
metastases
where does the gluteus maximus attach?
linea aspera of the femur
