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20 Cards in this Set
- Front
- Back
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Most of the blood supply to femoral head
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Medial and lateral circumflex arteries
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Hip range of motion
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Extension 20-30 degrees
Flexion 135 degrees Abduction 45-50 degrees Adduction 20-30 degrees |
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Intraarticular pathology of hip
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Labral tears
Ossified loose bodies Synovitis- Pigmented Villonodular Septic arthritis |
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Presentation of septic arthritis
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-Pain in anterior aspect of joint
- Pseudoparalysis - Fever - Possible trauma history - Hip positioning - external rotation, abduction and mild flexion - Most patients kids with no underlying disease |
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How do you evaluate septic arthritis
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- Get ESR, CRP, CBC
- Blood cultures (40-50% pos) - X ray - Ultrasound - Large bore needle aspiration |
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How do you interpret septic arthritis aspiration
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- WBC - 50000 cell/ml, 90% PMN
- Glucose level decreased - Gram stain - Cultures |
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Septic arthritis treatment
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- Early diagnosis
- Culture results - Hip arthrotomy |
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Common bacterial causes of septic arthritis
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- High risk low birth weight neonates - S. aureus followed by Strep group B
- 3 months-3 years - H.influenzae, staph, strep - Older then 3 years - Staph, strep |
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Legg-Calve-Perthes disease presentation
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- 4-10 years
- Boys - Small for age - Long term limp - No pain or mild knee pain - Limited internal rotation and abduction - Positive Trendelenburg |
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Where does pain from hip refers
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Suprapatellar region - femoral nerve
Medial thigh - obturator nerve Buttock - sciatic nerve |
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LCP treatment
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- Relief of weight bearing
- Bedrest, spicca, traction, slings - Restore mobility and relieve pain |
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Presentation of hip fracture
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Groin pain, thigh pain, knee pain
Typically shortened or externally rotated limb May or may not bear weight Passive and active motion is painful |
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X rays you take for hip fractures
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AP pelvis
AP hip Shoot-through lateral of hip MRI Bone scan |
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Intracapsular hip fractures
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Capital
Subcapital Transcervical Basicervical |
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Extracapsular fractures
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Intertrochanteric
Subtrochanteric |
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Anterior hip dislocations are caused by
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Result of abduction and external rotation
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Posterior hip dislocations are caused by
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Application of longitudinal force is applied in line with femur and acting on adducted hip
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How does posterior dislocation present
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Flexed at the hip, adducted and internally rotated
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How does anterior dislocation present
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Externally rotated with various degrees of flexion and abduction
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Treatment of hip dislocation
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Emergent reduction
Closed reduction is attempted first unless there is associated hip or femoral neck |
