The Groin And Pelvis: Exam 3

Question 1

How do the hip and pelvis move?

Answer 1

Multiple planes and through muscle function and gait

Question 2

What type of joint is the hip?

Answer 2

Ball and socket

Question 3

Does the hip have high or low stability?

Answer 3

High

Question 4

What is the most common structure in the hip and pelvis region?

Answer 4

Muscles

Question 5

Obersvation of hip and pelvis

Answer 5

• symmetry of hips and pelvis tilt
• lower limb alignment
• pelvic landmarks
• standing on one leg
• ambulation

Question 6

Lordosis

Answer 6

Sway back

Question 7

Pelvis landmarks

Answer 7

• ASIS
• PSIS
• iliac crest

Question 8

What should you look for hen asking patient to stand on one leg?

Answer 8

Pubic symphysis or drop on one side

Question 9

Functional evaluation special tests for the hip and pelvis

Answer 9

• ROM and strength

- hip adduction, abduction, flexion, extension, internal and external rotation

Question 10

Selective tissue testing

Answer 10

• hip flexor tightness
• sacroiliac joint
• iliotibilal band tightness
• gluteus medius weakness

Question 11

How does adductor or hip flexor strain (groin) happen?

Answer 11

Running, jumping, twisting with hip external rotation or severe stretch

Question 12

Symptoms of groin strain

Answer 12

• sudden twinge or tearing during active movement

- produces pain weakness and internal hemorrhaging

Question 13

Management of groin strain

Answer 13

• rice and NSAIDs for 48-72 hours
• rest is critical
• ROM once pain free

Question 14

How hip sprains happen

Answer 14

Unusual movement exceeding normal ROM may result in damage

Question 15

Symptoms or sprains

Answer 15

• signs of acute injury and inability to circumduct hip

- pain in hip region with hip rotation increasing pain

Question 16

Management of hip sprain

Answer 16

• x-ray or MRI to rule out fx
• RICE, NSAIDs
• ROM and PRE once pain free

Question 17

What causes a hip Labral tear?

Answer 17

Repetitive movements such as running or pivoting, resulting in degeneration or breakdown of labrum

Question 18

Can hip labral tear be acute?

Answer 18

Yes

Question 19

Symptoms of hip labral tear

Answer 19

• clicking, locking, stiffness, slipping
• limited ROM
• Diffuse pain thru groin and hip

Question 20

Management of hip labral tear

Answer 20

• hip ROM, strength, stability

- avoid painful movement

Question 21

When is surgery required in hip labral tear?

Answer 21

About 4 weeks

Question 22

What causes a hip pointer?

Answer 22

Contusion of iliac crest/ abdominal musculature and results from a direct blow

Question 23

Symptoms of hip pointer

Answer 23

• pain

- loss of function

Question 24

Management of hip pointer

Answer 24

• RICE 48 hours
• NSAIDs
• ic massage
• ultrasound
• ***steroid injection occasionally

Question 25

How long is recovery for hip pointer?

Answer 25

1-3 weeks

Question 26

Where is osteitis pubis most seen?

Answer 26

Distance runners, soccer, football, wrestling

Question 27

What causes osteitis pubis?

Answer 27

Repetitive stress on pubic symphysis and adjacent muscles

Question 28

Symptoms of osteitis pubis

Answer 28

- chronic pain and inflammation of groin - point tenderness on pubic tubercle - acute case may be the result of bicycle seat

Question 29

Management of osteitis pubis

Answer 29

- rest - NSAIDs - gradual return to activity - steroidal injection possible

Question 30

Athletic pubalgia

Answer 30

Chronic pain in pubic region

Question 31

What causes athletic pubalgia?

Answer 31

Repetitive stress to pubic symphysis from kicking, twisting, or cutting

Question 32

Symptoms of athletic pubalgia

Answer 32

- no hernia - point tenderness - pain increased with resisted hip flexion, internal rotation, abdominal contraction, resisted hip adduction

Question 33

Management of athletic pubalgia

Answer 33

- conservative treatment (rarely effective) - massage - stretching after 1 week - aggressive treatment involves cortisone injection or tightening of pelvic wall surgically