The hip and thigh Flashcards
What does development of the acetabulum depend on
The head of the femur being in its normal position and on movement of the joint
When does the epiphysis of the femoral head normally develop
4-5 months
What kind of gait may occur if the hip is painful
antalgic
What is a Trendelenburg gait
The pelvis tilts down on the opposite side of the disease hip
Sign of an abnormality with the abductor muscles
What conditions would present with a Trendelenburg gait
dislocation of the hip
Painful hip joint in OA
abnormality of the femoral neck, either being short or in a virus position
Describe the rotation of a hip in a femoral neck fracture
shortened and externally rotated on the side of a femoral neck fracture
Why is it difficult to determine tenderness of the hip
it is a deep joint
What are the movements of the hip joint
flexion and extension
abduction and adduction
internal and external rotation
How are abduction and adduction tested
Going the joint whilst the examiner keeps a hand on the opposite anterior superior iliac spine to detect pelvic movement
How is the true limb length measured
from the anterior superior iliac spine to the medial malleolus
What is the apparent length of the limb
from a midline point to the medial malleolus
What age group are affected by Perthes
boys aged 5-10
What are the clinical signs of Perthes
Minor , perhaps slight restriction of movements of the hip
What is seen on Xray in a patient with Perthes disease
Increased density of the epiphysis and widening of the medial joint space
How does healing occur on Xray of Perthes
gradual reabsroption of the dense bone and laying down of normal looking new bone
What is the treatment for Perthes disease
Position of abduction and internal rotation by either traction in bed or on an abduction frame
What is a slipped upper femoral epiphysis
a condition whereby the developing epiphysis of the hip, often in an overweight hypogonadal boy, partially slips, leading to hip pain or referred pain to the knee
What is the treatment for a SUFE
condition requires urgent surgical stabilisation with pins to prevent further stoppage of the epiphysis
When should septic arthritis in a child be suspected
Child presenting who is ill, toxic and unable to walk
Irritable and movement of the affected joint will not be possible because of pain
How is a diagnosis of septic arthritis in a child made
raised white cell count and erythrocyte sedimentation rate
What is the treatment for septic arthritis
urgent surgical drainage
What is irritable hip or transient synovitis
An effusion may occur in the hip of a child who has association with a generalised viral illness and
What is the usual infective organism of septic arthritis
Staph aureus
Where is pain form the hip joint usually felt in adults
In the groin or on the lateral or anterior aspect of the thigh
