The Hip

Question 1

Which leg is effected more often with Developmental dysphasia of the hip? (DDH) why?

Answer 1

The left due to intrauterine positioning of the hip in adduction against the mothers spine.

Question 2

In children what does hip problems often present as?

Answer 2

Referred pain in thigh or knee

Question 3

Transient synovitis

Answer 3

Inflammatory reaction of the hip joint, occurs after upper respiratory infection

Question 4

What is Leg calve perthes disease? Who is affected more often?

Answer 4

Expression of AVN of the femoral head, boys > girls

Question 5

What are two types of stress fractures?

Answer 5

1. Fatigue fractures

2. Insufficiency fractures

Question 6

What is a fatigue stress fracture?

Answer 6

Result of abnormal stress on normal bone. often associated with athletic activity

Question 7

What is an insufficiency stress fracture?

Answer 7

Result of normal stress on abnormal (demineralized) bone. Often associated with osteoporosis

Question 8

What are the two routine radiologic views of the hip?

Answer 8

1. AP

2. Lateral frog leg

Question 9

In what two ways can trauma be divided into at the pelvis?

Answer 9

1. Low energy injuries (avulsions, individual bone fractures)
2. High energy injuries (Disruption of the pelvic ring, life threatening)

Question 10

How are low energy pelvis injuries evaluated?

Answer 10

Routine projections, most common are AP oblique views of the pelvis

Question 11

How are high energy pelvic injuries evaluated?

Answer 11

High speed CT to obtain TAP or thoracic-abdomen-pelvis series.

Question 12

Major advantage of TAP?

Answer 12

Assess all serious bodily injuries in one time saving intervention

Question 13

Is it practical to employ a large number of sequences for MRI?

Answer 13

No, most facilities have an MRI protocol for the hip which includes certain anatomy and fluid sensitive sequences.

Question 14

What are 3 anatomy defining sequences?

Answer 14

1. T1
2. PD
3. GRE (Gradient echo)

Question 15

What are 2 fluid defining sequences of MRI?

Answer 15

1. T2 fat saturation

2. STIR

Question 16

When is CT used at the hip?

Answer 16

When spatial information about the bones and joint articulations is needed.

Question 17

What must US findings be correlated with in traumatic hips? (2)

Answer 17

1. MOI

2. Radiograph

Question 18

MSUS is ________ _________ imaging. Therefore, the operator can have the patient elicit what?

Answer 18

1. Real time

2. contractions, passive stretching, palpation, lesions not visible in the resting position.