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20 Cards in this Set

  • Front
  • Back
Most of the blood supply to femoral head
Medial and lateral circumflex arteries
Hip range of motion
Extension 20-30 degrees
Flexion 135 degrees
Abduction 45-50 degrees
Adduction 20-30 degrees
Intraarticular pathology of hip
Labral tears
Ossified loose bodies
Synovitis- Pigmented Villonodular
Septic arthritis
Presentation of septic arthritis
-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
How do you evaluate septic arthritis
- Blood cultures (40-50% pos)
- X ray
- Ultrasound
- Large bore needle aspiration
How do you interpret septic arthritis aspiration
- WBC - 50000 cell/ml, 90% PMN
- Glucose level decreased
- Gram stain
- Cultures
Septic arthritis treatment
- Early diagnosis
- Culture results
- Hip arthrotomy
Common bacterial causes of septic arthritis
- 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
Legg-Calve-Perthes disease presentation
- 4-10 years
- Boys
- Small for age
- Long term limp
- No pain or mild knee pain
- Limited internal rotation and abduction
- Positive Trendelenburg
Where does pain from hip refers
Suprapatellar region - femoral nerve
Medial thigh - obturator nerve
Buttock - sciatic nerve
LCP treatment
- Relief of weight bearing
- Bedrest, spicca, traction, slings
- Restore mobility and relieve pain
Presentation of hip fracture
Groin pain, thigh pain, knee pain
Typically shortened or externally rotated limb
May or may not bear weight
Passive and active motion is painful
X rays you take for hip fractures
AP pelvis
AP hip
Shoot-through lateral of hip
Bone scan
Intracapsular hip fractures
Extracapsular fractures
Anterior hip dislocations are caused by
Result of abduction and external rotation
Posterior hip dislocations are caused by
Application of longitudinal force is applied in line with femur and acting on adducted hip
How does posterior dislocation present
Flexed at the hip, adducted and internally rotated
How does anterior dislocation present
Externally rotated with various degrees of flexion and abduction
Treatment of hip dislocation
Emergent reduction
Closed reduction is attempted first unless there is associated hip or femoral neck