Ppii - Hip

Front 1

Ligmentum teres?
Iliofemoral?
Pubofemoral?
Ischiofemoral?
Transverse acetabular lig

Back 1

Ligmentum teres - limits F, ER, Add
Iliofemoral - limits E, ER, Add
Pubofemoral - limits E, ER, Abd
Ischiofemoral - limits E, IR, Abd

Front 2

Bursea in the Hip

Back 2

1. greater trochanteric bursa
2. deep trochanteric bursa
3. iliopsoas bursa
4. gluteus medius bursa
5. ischiogluteal bursa
6. ischial tuberosity bursa

Front 3

muscles change action due to the joint position and angle of fibres:
-piriformis
-gluteal medius

Back 3

-ER in <60 hip F and IR in >60 hip F
-hip Abd, ER in 30 hip F and IR in >30 hip F

Front 4

Femoral Triangle

Back 4

base - inguinal lig
lat border - sartorius
med border - add longus
inside - femoral VAN

Front 5

hip OA
risk factors
indications
Mx

Back 5

-obesity, dysplasia, age
-pain, stiffness, limited ROM in 3 planes, >50 y/o indicate high chance of hip OA
:- 1. multidisciplinary team approach
2. patient edu and self-Mx (age, sex, activity modification, exercise, weight reduction and methods of unloading arthritic joint)
3. medical Mx (meds, joint injections - hyaluronic acid, surgery)
4. physiotherapy (manual therapy, exercise therapy)

Front 6

hip dysplasia or instability in infants

Back 6

limited hip Abd in infants can be useful in identifying hip dysplasia or instability

Front 7

Muscle Length tests

Back 7

1. thomas test - iliopsoas, rec fem, TFL, Abd
2. prone knee bend - rec fem
3. obers - TFL
4. straight leg raise - hamstrings
5. adductors

Front 8

Hip Pathology

Back 8

Front 9

Slipped capital femoral epiphysis
-common age and sex
-Salter-Harris type
-symptoms
-can be influenced by?
-key predisposing factors
-Rx

Back 9

-children 12-15y/o and > in overweight boys
-type 1 fracture
-wadding gait, loss of hip range, ER foot and pain in knee/groin/hip
-influenced by endocrine disorders, obesity, femoral or acetabular retroversion and coxa profundus
-adolescent growth spurt and obesity
-orthopaetic surgery and failure to treatment may lead to avascular necrosis AVN

Front 10

Perths' Disease
-common age and sex
-description
-possible factors
-S+S
-Mx

Back 10

-kids 4-10 and > males
-idiopathic osteochrondrosis affecting femoral head - vascular interruption
-heredity, trauma, endocrine, inflammatory and nutritional
-antalgic gait, low grade pain in thigh/groin/knee and limited Abd, IR
-rest, maintenance of range, brace, possibly surgery
-OA may proceed due to irregularity of joint

Hint 10

Front 11

Stress #
-location most common
-sex, age, population
-symptoms
-imaging
-conservative Mx

Back 11

-femoral neck, femoral shaft less common
-females, endurance, adolescents, army recuits
-pain with WB activities, repetitive loading
-bone scan, XR, MRI
-cease WB activity, proprioceptive and motor control training, slow progression back into sport with monitoring of site, stabilisation surgery

Front 12

Labral Tear
-most common
-Hx of injury
-S+S
-further problems
-which test test to use
-Imaging
-conservation Mx

Back 12

-intra-articular hip injury in athletic populations
-single or repetitive trauma - rot and flexion, FAI can increase chance of labral tear
-clicking, locking, catching, giving way and pain located ant/posteriorly or groin
-vascularisation can hinder healing and lead to OA
-FABER
-MRI most sensitive and arthroscope is gold standard
-deloading, avoidance of repetitive mvts, lumbopelvic proprioceptive training and motor pattern correction of deep stabilising muscles
-possibly surgery

Front 13

Femoroacetabular Impingment (FAI)
-3 types
-common position for impingment

Back 13

-cam: increased bone formation at the anterior surface of femur - decreased femoral head-neck offset
pincer: bony growth at acetabulum generally anterior
mixed: both cam and pincer bony changes are presented
-F + IR + Add

Front 14

Osteitis pubis
-commonly known as:
-causes
-multiple pathologies
-Ax
-imaging
-Mx

Back 14

-sportsman's groin
-repetitive mircotrauma, training overload
-add tendonitis, pubic bone edema/stress reaction/periostitis pubis
-+ve squeeze test
-XR, bone scan, MRI
-1. lumbopelvic and hip stabiliser motor control - decrease hip F/IR
2. optimal length and strength - Add weakness
3. pain free exercises
surgery, botox

Front 15

Snapping Hip
-caused from
-common age, sex
-associated with activity
-symptom
-Mx

Back 15

-iliopsoas "snaps" over the iliopectineal eminence
-young females
-repetitive hip F
-deep clunk when bringing hip from F to E - noise can be modified if put pressure over the tendon
-improving hip extension, length of iliopsoas, hip rot strength

Front 16

Greater Trochanteric Pain Syndrome (GTPS)
-also referred to as:
-pain where
-risk factor
-GTPS vs OA

Back 16

-tendinopathies of the gluteal tendons and bursa
-lateral hip area:
glut med/min tendinophy
glut med/min tears
trochanteric bursitis
-lower neck shaft angle
-lateral pain on palpation, no difficulty in putting on shoes, reproduction of pain with FABER