SCS Study Guide- Hip Flashcards
RF, VL, MS, VI innervation by
femoral nerve L2-3
biceps femoris innervation
sciatic nerve L5-S3
semitendinosus, semimembranosus and popliteus
tibial nerve L4-S1
adductor longus, brevis, magnus, pectineus and gracilis are innervated by the
obtruator L3-4
psoas major and minor innervation
femoral and first lumbrical
liacus, TFL, Glute med and glute min innervated by
superior gluteal
glute max innervatin
Inf glute l5-s2
piriformis innervated by
second sacral
superior gemellus innervtion
5th lumbar, first and second sacral
inferior gemellus innervation
4th and 5th lumbrical and first sacral
ontruator internus
5th lumbar, first sacral
obtruator externus
obtruator
teres ligament resists…
hip flex, abd and ERi
liofemoral ligament is AKA and resists
Y ligament, resists ext and ER
ischiofemoral ligament resists…
adduction with hip flexed and IR
pubofemoral ligament resists…
hyperabduction and ER
caxa valga limits
over 140
coxa vara limits
under 120
normal angle of inclination
125
what is normal torsion
12-15 degrees
anteversion is an ____ angle of torsion and creates toe ___
increased, toe in
retroversion is an ____ in angle of torsion and creates a toe ___
decreased, toes out
thomas test
hip flexxors
FABER test
SIJ and hip impliocations, pain in front of the hip
renne’s test
pain from TFL
ely’s test
tightness in RF
log roll
internal hip patholgy (intra-artucular)
FADIR
hip impingment and FAI
dial test
anterior laxity
pace sign and freiber sign
piriformis
craigs test
anteversion of hip
percussion test
freacture of LE
c-sign
hip to groin pain
quad contusion
cause, exam and treatment
direct blow, pain and loss funciton, brusing, RICE and ROM
cause, exam and treatment heterotrophic ossification (myositis ossificans)
when do imaging
blow to thigh, ossification follow hematoma (hemorrage that can calcify)
pain, weak, tissue tension,
xray 2-6 weeks out surgery if after 1 year
femoral fracture appearance
hip in ER and slight ABD, making it look shorter
how do you treat a femoral fracture
4 months are out, open or closed
femoral fracture wehre has the greatest risk for AVN
across the epiphysis
femoral stress fracture cause exam and treatment
cause: endurance/overuse
exam: graudal inc pain over weeks, pain in groin, anterior thigh, knee, WB worse, AP x-ray but also bone scan,
treatment: rest 2-5 months converstively
quad strain cause, exam and treatment
cause: sudden and forceful contraction of the hip and knee into flexion with the hip extended
exam: pain, limited ROM, antalgi gait
RICE, compression, avoid overstretching
HS strain cause, exam and treatment
DURING WHAT PHASE
cause: changes in direction and speed during terminal swing phase
exam: hemorrage and bruising, pain and antaligic gait
most common muscle strain is
HS strain
adductor strain cause, exam and treatment
cause: running, jumping, twisting with hip in ER
exam: pain at end of activity, weakness and antalgic gait
RICE and conservative treatment
hip dislocation cause, exam and treatment
cause: force with knee bent, usually postreior
exam: thigh and palpation, thigh looks IR, flex and ADDD
TTP, swelling, AVN IS A RISK
SCFE cause, exam and treatment
boys, tall/thin or obese
groin pain, limitations in ABD/FLEX /IR, walk with a limp
need NWB
what is a view of x-ray to see SCFE
frog leg or klin’es line
how might SCRE presents
leg may be in ER making it look shorter
LCP cause, exam and treatment
AVN femoral head, kids 4-10, moe common in boys
groin pain, referred to the knee, limping, gradual with no MOI,
rest avoidance of WB and time to treat
imaging for LCP
frog leg and AP, and MRI !! best!!
where are the two sites of snapping hip
iliopsoas over the iliopectineal eminence, pr the ITB over the GT
how do you differentiate, on exam, iliopsoas vs ITB snapping hip
iliopsoas is hear across the room,
ITB is see across the room
both feel unstable
treatment snapping hips
anti-inflammatories, address mobility restrictions and hip stability exericses
labral tear cause, exam and treatment
cause: forced ER in extension, repetitive movement and degeneration
exam: pain/click/clunk/lock
conserve for 4 weeks, then debrde or repair
hip pointer cause, exam and treatment
cause: iliac crest contusion, blow to iliac crest
exam: pain and bruising and difficulty rotating trunk
treatment/l RICE, x-ray and protection to area
pelvic stress fracture/osteitis pubis cause, exam and treatment
cause: overuse, repetitive stress and inflammation
exam: insidious onset, pain at pubic symphysis, better with NWB
treatment: rest, anti-inflam and grad RTP
athletic pubalgia cause, exam and treatment
cause: repetitive stress from kick/twist/cutting/shear force from ADD and hyperxxt
exam: pain in groin, inc with resisted flex/IR/abdominals and radiates into inner thigh
treatment: conservative, cortisone injection and surgery
labral repair
-weeks of ROM
-have to limit what
-running RTP
1-2 weekspain free ROM
limiti hip flexion 4 weeks
no running before 12 weeks
hip debridement restrictions
none, WBAT, rom as tolerated and progress as tolerated
hip osteoplasty , WB restriction, avoid what position, and ROM
initally, PWB at 20lbs, then 4-6 weeks, WBAT ten at 9 weeks progress as tolerated.
1-2 weeks ROM
limit hip flex to 4 weeks
hip post op capsular modification, ROM, WB, limit what, and running RTP
1-2 weeks ROM
WBAT
limit ER and ext for 4 weeks
no running before 12 weeks
microfracture restrictions on ROM, limit what, WB status, and RTrunning
ROM 1-2 weeks pain free
limit hip flex 4 weeks
20 lbs PWB beginnig
4-6 weeks WBAT
running 12-16 weeks
hip OA clusters 1 and 2
cluster 1: hip pain, IR <15 degrees, flex <115
cluster 2: (if IR>15)… painful IR, age>50, morning stiff >60 minutes
CPR or hip OA
IR < 25 degrees
squatting aggrevates
flex ROM causes lat hip pain
scour or groin pain
pain with extension
anterior hip replacement precautions
avoid hyperextension, ER and prone lying
posterior hip replacement precautions
no flex past 90, no crossing midline and no IR
