Pelvis/Hip

Question 1

Recommended projections for hip:

Answer 1

AP

Lateral

Question 2

What projection is osseous pelvis evaluated with?

Answer 2

AP

Question 3

Iliopectineal (Iliopubic) line

Answer 3

this line represents the anterior column

line from sciatic notch to pubic tubercle representing limit of anterior column of acetabulum

Question 4

Ilioischial line

Answer 4

this line represents the posterior column

line from iliac notch to inner surface of ischium representing posteromedial margin of quadrilateral surface o

Question 5

Anterior lip of acetabulum

Answer 5

represents the anterior wall of the acetabulum

Question 6

Posterior lip of acetabulum

Answer 6

represents the posterior wall of the acetabulum

Question 7

Fracture of acetabular roof:

Answer 7

represents superior cortical aspect of acetabular cup, which corresponds to major weight-bearing portion of acetabulum

Question 8

Fracture of anterior acetabular rim:

Answer 8

represents anterior margins of acetabular cup

Question 9

Fracture of posterior acetabular rim:

Answer 9

represents posterior cortical rim of acetabular cup

Question 10

Coxa vara

Answer 10

angle less than 130

Question 11

Coxa Valga

Answer 11

angles greater than 130

Question 12

Most common disease of hip?

Answer 12

DJD referred to as OA

Question 13

Primary etiology of DJD at hip:

Answer 13

developing without a clear precursor

Question 14

Secondary etiology of DJD at hip:

Answer 14

directly related to some predisposing trauma or pathological condition

Question 15

Secondary hip OA may be due to:

Answer 15

Fracture
Paget’s disease
Epiphyseal disorders
Congenital dislocation
Avascular necrosis (AVN)
Other inflammatory arthritides

Question 16

Radiographic hallmarks of DJD at hip joint include:

Answer 16

Joint space narrowing
Sclerotic subchondral bone
Osteophyte formation at joint margins
Cyst or pseudocyst formation
Migration of femoral head

Question 17

What are cysts a result of:

Answer 17

degeneration of articular cartilage

Question 18

Goals of conservative treatment of hip DJD:

Answer 18

decrease pain
Restoring flexibility and strength
Preserving functional activities and ambulation with assistive devices to unload joint from full weight-bearing stresses

Question 19

Rheumatoid arthritis:

Answer 19

a progressive, systemic, autoimmune inflammatory disease primarily affecting synovial joints

Question 20

Clinical features of RA:

Answer 20

Morning joint stiffness
Bilateral and symmetrical swelling of joints
Pain and functional disability
Rheumatoid nodules
Positive rheumatoid factor test
Radiographic changes consistent with RA

Question 21

RA of hip characterized by:

Answer 21

Osteoporosis of periarticular areas becoming more generalized with advancement
Symmetrical and concentric joint space narrowing
Articular erosions located either centrally or peripherally in joint
Synovial cysts located within nearby bone
Periarticular swelling and joint effusions
Axial migration of femoral head
Acetabular protrusion

Question 22

Where is OA of the hips usually first seen?

Answer 22

femoral head

Question 23

What is an acetabular protusion?

Answer 23

an expansion of acetabulum into pelvis

Question 24

What is the distinct difference between DJD and RA?

Answer 24

rheumatoid arthritis has minimal or absent reparative processes

Question 25

Osteochondritis dissecans:

Answer 25

If an infarction affects local segment of bone, AVN | Most often seen in weight bearing bones

Question 26

Epiphyseal ischemic necrosis

Answer 26

An infarction that affects entire epiphysis in a growing child Proximal femur is most common location

Question 27

3 categories that can disrupt osseous blood supply:

Answer 27

Conditions that result in external blood vessel compression or disruption near/within bone such as trauma, infection, or steroid administration Conditions that result in blood vessel occlusion b/c of thickening of vessel wall such as radiation therapy, systemic lupus erythematosus, or giant cell arteritis Conditions that result in blood vessel blockage from thromboembolic process such as alcoholism, diabetes, or sickle cell disease

Question 28

What is sclerosis and cyst formation at femoral head a characteristic sign of?

Answer 28

initial necrotic processes and healing attempts taking place

Question 29

What is the most appropriate study for early sensitivity and specificity in diagnosing AVN?

Answer 29

MRI

Question 30

Conservative treatment of AVN of femoral head?

Answer 30

``` Prolonged avoidance of weight-bearing Traction Bracing Casting Exercise ```