Thigh, Hip, Groin, and Pelvis

Question 1

Ligaments of the hip

Answer 1

pubofemoral, iliofemoral, ischiofemoral

prevent extension of hip

Question 1

Bursae of the Hip

Answer 1

Iliopsoas (↓ friction b/w iliopsoas + articular capsule)

Deep trochanteric (greater trochanter and gluteus max at iliotibial tract)

GLuteofemoral (gluteus max - vastus lateralis)

Ischial (cushions for sitting)

Question 2

3 compartments of the thigh

Answer 2

Anterior (hip flexors)

Medial (hip abductors)

Posterior (hamstrings (does not include pelvis, those are pelvis)

Question 3

Lateral Rotators

Answer 3

under gluteus max.
posterior pelvis
external rotators
6 of them

Question 4

Myositis Ossificans Traumatica

Answer 4

MOI: blunt force trauma and improper care after

S/S pain, weakness, swelling, point tender, ↓ ROM and function

M: refer, potential surgery, Prevention & proper care is KEY!

Question 5

Femoral Fractures

Answer 5

MOI: trauma, direct blow, MVA (usually to shaft), increase in Elderly, osteoporotic women

S/S: swelling, crepitus, disability, muscle guarding, hip adducted & ER

M: 911, immobilize & splint, ice, treat for shock, monitor

Question 6

Avulsion Fracture

Answer 6

MOI: muscle pulls off bone, over-stretching / violent muscle contraction

common areas:
1. Ischial Tuberosity (hamstrings)
2. ASIS (sartorius)
3. AIIS (rec fem)
4. Pubic Ramus (adductors)

S/S: limited AROM + weakness

M: PIER, protect, refer

Question 7

Femoral Stress Fracture

Answer 7

MOI: overuse (10-25%), downhill running/ jumping, endurance athletes, nutrition

S/S: walk w/ antalgic gait, positive trendelenburg’s

M: depends on location
# lateral more complicated, # medially heal w/ conservative

Question 8

Compartment Syndrome in thigh

Answer 8

MOI: direct blow, extensive bleeding (lateral anterior most common)

S/S: 5 Ps

M: 911

Question 9

Sprain hip joint

Answer 9

MOI: unusual movement, force over planted foot in opposite direction

S/S: similar to stress fracture

M: X-ray, MRI, RICE, NSAID, (crutches), ROM and PRE are delayed until hip is px free

Question 10

Avascular Necrosis

Answer 10

MOI: temp/ perm loss of blood to prox fem, none/traumatic conditions

S/S: joint px w/ weight bearing, osteoarthritis may develop, progressively gets worse

M: x-ray, MRI, CT scan, improve use of joint, stop further damage, surgery most likely

Question 11

Hip Problems in the young athletes

Answer 11

Legg Calves’-Perthes DIsease (Coxa Plama)

MOI: avascular necrosis (4-10 year olds), trauma =25% cases

S/S: px referred to abdomen or knee, limping

M: bed rest, brace, treat early or else develop into osteoarthritis later in life

Question 12

Slipped Capital Femoral Epiphysis

Answer 12

MOI: boys 10-17, who are tall/thin/obese

S/S: limited abd, flex, med rot w/ limp

M: surgery, w/ minor rest and non-weight bearing

Question 13

Osteitis Pubis

Answer 13

MOI: repetitive stress on pubic symphysis

S/S: point tenderness, px w/ running, sit-ups and squats

M: rest, NSAID, gradual return

Question 14

Athletic Pubalgia

Answer 14

Sports hernia
MOI: repetitive stress to pubic symphysis, microtears of abdominis

S/S: no presence of hernia, point tenderness on pubic tubercle

M: conservative, may need surgery