What - Hips Flashcards
Look at the patient’s gait and lower limbs while standing
1. What are four main causes of an antalgic gait (painful to weight bear) related to the h
Four main causes of antalgic gait related to the hip are:
a. Arthritis
b. Injury
c. Infection
d. Inflammation
What part of the spine is immediately underneath the ‘Dimples of Venus’?
The Dimples of Venus are at the level of, part of, the sacroiliac joint
What important structures lie over the greater trochanter of the hip? What illness could cause tenderness across the
greater trochanter?
The greater trochanter of the hip has a bursa overlying it for easy gliding of the gluteus medius and gluteus minimis
tendon attachments. The IT band also lies lateral to the bursa. Pressure from this structure can lead to trochanteric
bursitis, however inflammation is rarely involved in the disease process. Rather these conditions are more commonly
degenerative in nature and more of a “tendinosis” from gluteal muscle (G.medius and G.minimis) weakness & inactivity.
Thus, the more fitting name of Greater Trochanteric Pain Syndrome.
Using the VITAMIN D acronym, what are some causes of soft tissue swellings in the inguinal area?
V – femoral artery aneurysm, thrombophlebitis, lymphedema
I – local infection or inflammation of soft tissue structures
T – haematoma, hernia, neuroma, foreign body penetration
A – lymphadenopathy secondary to AID
M – obesity
I – foreign body left in during operation
N – any localized malignant mass, secondary lymphadenopathy
D – warfarin–>increased bruising
What could increased lumbar lordosis indicate
Increased lumbar lordosis may be a normal finding in females, or in pregnancy, truncal obesity or spondylolisthesi
What condition may have tender sacroiliac joint
Tenderness over the sacroiliac joints is highly suggestive of ankylosing spondylitis (AS), particular with other symptoms
and signs of AS (spinal pain, loss of lumbar lordosis, increased thoracic kyphosis, head in forward position with greater
than zero cm occiput to wall measurement, restricted movement of thoracolumbar spine, reduced chest expansion and
weak back muscles, restricted modified Schober test
What are the landmarks for measuring leg length discrepancy and how much shortening is clinically significan
Landmarks for measuring leg length discrepancy:
Anterior superior iliac spine (ASIS) to medial malleolus (can also use patella/tibial tubercle for halfway point)
Shortening >0.5 cm is clinically significant
What muscles are involved in hip flexion? Hip extension? Hip abduction? Hip adduction
Hip joint movements and muscles:
Hip flexion – iliopsoas muscle
Hip extension – hamstrings and gluteus maximus muscles
Hip abduction – gluteus medius muscle
Hip adduction – adductors = longus, brevis and magnus muscles
What does Thomas’s test test for?
Thomas’s test is performed to look for a fixed flexion deformity (masked by increased lumbar lordosis – flexion of the
contralateral hip to 90 degrees eliminates any increased lumbar lordosi
What is considered a positive FABER test?
In relation to the hip joint, a positive FABER test is when the patient’s groin pain is reproduced (hip joint pathology is
usually felt in groin).
What is considered a positive external derotation test? What does it mean?
Positive external derotation test is when the patient’s postero-lateral hip pain is reproduced. Supportive of a gluteal
tendinopathy
What two functions of the hip does the Trendelenberg test consider
Trendelenberg test is performed to test for:
a. Weakness of the hip abductors (gluteus medius)
b. Hip disease
