Pelvis Hip and Thigh Injuries Flashcards
what is a leg-calve-perthes
AVN of the femoral head
MOI of leg-calve perthes
unknown etiology
history of leg-calve-perthes
-usually children ages 4-10 with 4:1 males, 20% bio -pain in groin, thigh or knee -insidious onset usually with a limp
what will be found on physical examination of a leg-calve-perthes
- no internal or external hip rotation
- pain with motion
- hip or knee/thigh pain
what type of gait will be seen with a leg-calve-perthes
Trendelenburg gait
radiographs of a leg-calve-perthes will show what
-increased radio density (sclerotic changes)
what is the treatment of leg-calves perthes
- conservative with rest, crutches, PT
- containment of head in acetabulum with casting or bracing
- surgery in severe cases of Ped. Ortho
what is the history of a slipped capital femoral epiphysis (SCFE)
- children usually male ages 10-14, rapidly growing -bilateral 50% of the time
- insidious onset with hip, groin, thigh, knee pain
- obese male, delayed development usually
what will be found on physical exam of a slipped capital femoral epiphysis
- spasms, synovitis, reduced ROM
- observe external rotation with hip flexion
what is the treatment for a slipped capital femoral epiphysis
surgical reduction
- major difference btwn LCP
what history is common with Trochanteric Bursitis
- tight IT band
- runner with trochanteric pain during flexion and extension (increased with coxa varum)
what is the MOI of Trochanteric Bursitis
- commonly the result of overuse rather than direct trauma
- pain may radiate to the groin or in approximately 1/3 of patients, pain will radiate into the lateral thigh
what is evident upon PE of trochanteric bursitis
- while lying down on the unaffected side, leg extended have pt flex hip
- produces an aching pain over the lateral hip that is exacerbated by activity such as prolonged standing lying on the ipsilateral side, stair climbing, or running
- pain is reproduced w/ external rotation and abduction and by resisted abduction
- ITB tightness may be present
what test is positive in a trochanteric bursitis
ober test
what is the ober test
- the patient lies in the decubitus position with the affected leg up
- the examiner lowers the knee to the table to assess for IT band tightness
what is the treatment of Trochanteric Bursitis
- modify activity: do not flex/extend hip and less varus tension
- IT band stretching
- steroid injection
- evaluate for other causes if conservative tx fails
Paulska states that bursitis is due to
repetitive activity or acute trauma, may affect the trochanteric, ischial or iliopectineal bursar