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313 > Readings - Hip > Flashcards

Readings - Hip Flashcards

1
Q

If a pt does not have painful clicking, what can we mostly rule out ?

A

Labral tear

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2
Q

List 6 common causes of anterior hip pain

A
  1. Labral tear
  2. Chondropathy
  3. OA
  4. Synovitis
  5. Groin related pain
  6. Ligamentum Teres tear
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3
Q

List 4 not to be missed causes of anterior hip pain

A
  1. Avascular necrosis of femoral head
  2. Synovial chondromatosis
  3. Slipped capital femoral epiphysis
  4. Perthes disease
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4
Q

Most common cause of lateral hip pain

A
  1. Glute med. tear or tendinopathy
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5
Q

List 3 not to be missed causes of lateral hip pain

A
  1. Tumour
  2. Nerve root compression
  3. NOF #
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6
Q

What is a highly sensitive test for a labral tear ?

A

FADIR

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7
Q

List two PROMs for hip pathology

A
  1. Copenhagen hip and groin outcome score

2. Hip dysfunction and OA outcome score

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8
Q

List two highly sensitive tests when testing OA

A
  1. Passive internal rotation less than 25 degrees

2. Pain with active hip extension

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9
Q

Pain and reduced range on a Thomas test can confidently indicate what?

A

Non-specific Intrarticular pathology and length of hip flexors

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10
Q

What is the close-packed position of the hip joint ?

A

Extension, adduction and IR

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11
Q

Femoral retro version might limit what movement ?

A

Internal rotation

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12
Q

Acetabular retroversion may limit what movement

A

Internal rotation

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13
Q

How might foot probation impact the hip?

A

Lead to internal tibial rotation, in turn leading to overload on the ITB. Increased ITB tension adds further compressive force on the greater trochanter, potentially cause tendinopathy or bursitis.
Internal tibial rotation may also lead to femoral internal rotation, adding further joint reaction force to the acetabular

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14
Q

Define a CAM Femoral-acetabular impingement

A
  • morphological abnormality on the head-neck junction of femur
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15
Q

Define a Pincer Femoral-acetabular impingement

A

Morphological abnormality on the acetabulum

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16
Q

What movements are problematic in Pincer FAI

A

Hip flexion

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17
Q

What movements are problematic in CAM FAI

A

Hip flexion and internal rotation

18
Q

What should those with FAI be instructed to avoid ?

A

The position of impingement

19
Q

What is the position of impingement in FAI

A

Flexion, IR and adduction

20
Q

For sports, what activity modifications should be made for a pt with FAI

A
  • reduce COD and getting low (extreme flexion) where possible
  • positional change ?
21
Q

What two disorders of the hip can increase risk of Labral tear

A
  1. Cam-type FAI

2. Developmental dysplasia of the hip

22
Q

Patients with labral tears are 40% more likely to have coexisting what?

A

Chondropathy

23
Q

How might a damaged labrum lead to hip chondropathy

A
  1. Reduced chondral nutrition via synovial fluid

2. Reduced load bearing capacity in damaged labrum - force therefore transmitted to the bony surfaces

24
Q

What position and degree of movement in gait puts greater stress on the anterior soft tissue in the hip

A

Last 20-30% of stance phase, which consists of 5 degrees hip extension

25
Q

What gait retraining can be done for a labral pathology

A
  • minimising hip extension at the end of stance phase
26
Q

Ligamentum Teres tears commonly occur with what injuries

A
  1. FAI
  2. Dysplasia
  3. Synovitis
27
Q

Ligamentum Teres tear management is mostly managed similarly to labral pathology, with a particular emphasis on what two exercise principles ?

A
  1. Regaining neuromotor control

2. Proprioception at the hip

28
Q

What other pathologies increase chondropathy and ultimately OA of the hip ?

A
  1. FAI
  2. Decreased acetabular anteversion
  3. Labral pathology
  4. DDH
29
Q

What 3 pathologies are associated with hip instability ?

A
  1. Cam-type FAI
  2. Ligamentum Teres tears
  3. Excessive anteversion
30
Q

What are the most provocative loading positions for someone with hip pathologies to be avoided ?

A
  1. Rotational loads
  2. Loading at EOR
  3. Overload in the impingement position
31
Q

Should the glute max be retrained in intra-articular hip pathology and if so why?
What position is best to begin retraining ?

A
  • Yes
  • it provides hip stabilisation by resisting anterior hip forces
  • prone isometric external rotation against minimal resistance
32
Q

Thickening of the ITB and bursae is an adaptive response to what?
And how does this affect

A
  • repetitive compressive forces

- thickening leads to reduced tensile loading capacity

33
Q

What joint positions strongly influences lateral soft tissue compressive loading of the hip joint ?

A

Adduction

34
Q

Lateral hip pain with lack of tenderness palpated over the lateral hip would indicate what?

A
  • other more remote conditions should be considered rather than lateral hip pain causing pathology
35
Q

In lateral hip pathology, what FABER result would you expect ?

A
  • normal or minimally limited range but reproduction of lateral hip pain
36
Q

List 1 test with good sensitivity and specificity for detecting a gluteal tendinopathy in lateral hip pain

A
  1. SLS and reproduction of pain over the GT within 30 seconds of standing
37
Q

What positional habits should be avoided in lateral hip pain

A
  1. Sitting with knees crossed or together
  2. Hip hanging whilst standing
  3. Side lying
38
Q

In runners with lateral hip pain, what education should be given

A
  • run on flat surface, mostly straight line running

- hill running avoided

39
Q

List one early hip exercise for lateral hip pain

A
  1. Isometric hip abduction to minimise compression
40
Q

Use of Clams in lateral hip pain?

A

May be provocative and should be avoided

41
Q

What does the Ober’s test tell us ?

A

Assess tightness in the TFL and therefore tightness of the ITB

42
Q

Reducing step length should be considered for what to injuries ?

A
  • tib ant tendinopathy

- GTPS

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