Screening for Lower Quadrant: Buttocks, Hip, Groin, Thigh

Question 1

What are three important steps when differentially diagnosing?

Answer 1

1. look for red/yellow flags in pt history
2. review of systems like GI, GU, CV
3. examination

Question 2

What are Cyriax signs?

Answer 2

results can be indicative of serious gluteal pathology (OM, fx, abcess) which are:

1. limited and painful SLR
2. limited and painful hip flexion with knee flexed
3. non capsular restrictive pattern (IR, ABD, Flex)

Question 3

What are S and S of colon cancer?

Answer 3

LBP that doesn’t go away, over 50 years old, bowel disturbance, weight loss, family history

can r/o with colonoscopy or fecal test

Question 4

What is common with pathologic fx?

Answer 4

over 70 female, hip groin or thigh pain

fall from standing position leads to severe pain with movement leg is shortened and in ER

Question 5

What is usually causes of AVN?

Answer 5

steroid use, previous AVN, trauma

yellow flag

Question 6

What is Legg Calve Perthes?

Answer 6

AVN of fem head in young boys 2-13, gradual onset of hip, groin,thigh, knee pain

shorter limb loss of ER, ABD and IR

similar to osgood slaughters in knee self limiting and may or may not require PT as pain comes and goes

Question 7

What is SCFE?

Answer 7

med emergency, head of femur slips in usually boys 10-17 y/o, could be from trauma or no trauma, pain in same areas as LCP but never gets better with shorter limb, trendelenburg

Question 8

What is the cause of a psoas abcess?

Answer 8

type of infxn, recent belly or hip surgery, diabetic hx

Question 9

What are tests to rule in or out psoas abcess?

Answer 9

heel tap, hop test, MMT of HF, palpation of iliopsoas (rebound tenderness)

Question 10

What are two types of stress fractures?

Answer 10

1. insufficiency- usually in older folks with osteoporosis

2. fatigue- overtraining- usually pain after activity

Question 11

What can dx a stress fx?

Answer 11

fulcrum test and must have an MRI or bone scan

Question 12

What are risk factors for PAD?

Answer 12

over 60 years old, type 2 DM, CAD, smoke, sedentary

Question 13

What are sx of PAD?

Answer 13

intermittent claudication, cool extremity, decreased pedal pulse, abnormal ABI

Question 14

What are ABI findings?

Answer 14

1 is normal under 1 they need a referral

less than 0.5 is severe PAD may require surgery

Question 15

What is difference between acute and chronic compartment syndrome?

Answer 15

acute- med emergency

chronic- likely from ms imbalances still have a pulse will benefit from PT

Question 16

What are causes of acute CS?

Answer 16

trauma, burns or recent casting

Question 17

What are sx of Acute CS?

Answer 17

swelling with severe tenderness, parathesia, no pedal pulse

Question 18

What is septic arthritis?

Answer 18

constant pain with sweeping warmth and tenderness due to recent infection surgery or injection

sx: can’t move joint, warm over jt, systems fever is lasts awhile

MED EMERGENCY

Question 19

What is cellulitis?

Answer 19

same sx as septic arthritis except from an open cut or laceration

usually have history of CHF, venous insufficiency or cirrhosis or immunocompromised pts

MED emergnecy