Pelvis and Hip 2

Question 1

where is the position of the hip socket where impingement normally occurs?

Answer 1

12 to 2 o clock position - anterior / superior position

Question 2

what muscle stabilizes the hip during hip motion and weightbearing?

Answer 2

gluteus medius

Question 3

where do the adductor muscle originate?

Answer 3

pubis

Question 4

t/f there is a clinical association between FAI and athletic pubalgia

Answer 4

true

Question 5

which fascial structure is at the core of understanding athletic pubalgia?

Answer 5

pubic aponeurosis

Question 6

describe the attachments of the direct and indirect head of the rectus femoris at the hip

Answer 6

direct - originates at the AIIS
indirect - broad attachment to the acetabular rim

Question 7

where does the piriformis originate?

Answer 7

anterior surface of the sacrum

Question 8

the blood supply of the femoral head is largely supplied by what artery?

Answer 8

deep branch of the medial femoral circumflex artery

Question 9

what nerve root supplies most of the innervation to the hip

Answer 9

L3

Question 10

what is the reason that hip pathology can be referred to the medial leg?

Answer 10

hip and medial leg are both supplied by the L3 dermatome

Question 11

describe the relative course of the lateral femoral cutaneous nerve relative to the inguinal ligament

Answer 11

exits the pelvis UNDER the inguinal ligament

Question 12

what bony structure separates the greater and lesser sciatic notch?

Answer 12

ischial spine

Question 13

in an avulsion injury of the proximal hamstrings, what degree of retraction should prompt surgical referral within 6 weeks of injury?

Answer 13

3cm or more retraction of the tendon

Question 14

for an avulsion injury of the proximal hamstring with less than 3 cm retraction , non operative treatment with what injection can be offered initially?

Answer 14

PRP

Question 15

what is the treatment for the vast majority of rectus femoris injuries?

Answer 15

conservative management

Question 16

what ligament attaches the femoral head to the acetabulum?

Answer 16

ligamentum teres

Question 17

what is the treatment for gluteus tendon avulsion?

Answer 17

early surgical repair

Question 18

what are the three subtypes of FAI?

Answer 18

CAM, pincer and mixed

Question 19

when does the external iliac artery become the femoral artery?

Answer 19

after crossing underneath the inguinal ligament

Question 20

which condition causes misshapen femoral head, shallow acetabulum, excessive anteversion of the acetabulum and proximal femur?

Answer 20

DDH

Question 21

what is the ultimate treatment for FAI?

Answer 21

surgery (including labral repair component)

Question 22

describe the center edge angle of Wiberg on a radiograph when assessing hip dysplasia?

Answer 22

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

Question 23

what center edge angle of Wiberg measurement is considered dysplastic?

Answer 23

20 degrees or less

Question 24

describe the relative difference in pain sitting/standing between FAI and DDH, which can help to differentiate these conditions

Answer 24

DDH - more pain with standing
FAI - more pain with sitting

Question 25

dysplasia of the hip joint could be in either or both of what two directions?

Answer 25

lateral and anterior

Question 26

t/f in a case of DDH, in patients with degenerative cartilage, surgery to preserve the hip joint is contraindicated

Answer 26

true

Question 27

ischiogluteal bursitis is inflammation in the bursa found between what two structures?

Answer 27

gluteus maximus and ischial tuberosity

Question 28

how would you differentiate ischial bursitis from hamstring injury on physical exam?

Answer 28

absence of pain with stretching - indicative of bursitis

Question 29

80% of acute hamstring injuries occur in what muscle?

Answer 29

long head biceps femoris

Question 30

for how long minimum should you allow for recovery for a grade 1 / 2 hamstring injury?

Answer 30

4 weeks

Question 31

what are the three main osseous areas of the hip where avulsion can occur in athletes?

Answer 31

AIIS (rectus) , ASIS (sartorius) and ischial tuberosity (hamstring)

Question 32

the insertion of what two adductor muscles can be related to medial femoral shaft stress fractures?

Answer 32

adductor longus and brevis

Question 33

a patient is found to have osteoid osteoma of the femur. what is the typical treatment?

Answer 33

radiofrequency ablation

Question 34

what type of fracture is associated with chronic bisphosphonate use?

Answer 34

atypical femur fracture

Question 35

what percentage of cases of atypical femur fracture have bilateral occurrence?

Answer 35

50%

Question 36

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?

Answer 36

metastases

Question 37

where does the gluteus maximus attach?

Answer 37

linea aspera of the femur