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29 Cards in this Set
- Front
- Back
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when you palpate the greater trochanter, what are you looking for?
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bursitis
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what is the scale for the muscle strength portion of the neurovascular exam?
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0- no contractility
1- slight contractility 2- no gravity 3- gravity only 4- some resist 5- normal |
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what is the trendelenburg?
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a glutus medius test: have the pt stand an lift one leg, the side the sags is the strong side, the opposite glute is the problem.
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what is the ober test?
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test that indicates the tightness of the IT:
pt can't put knee on table because IT band is too tight. |
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what is the thomas test?
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pt supine, knees bent, one leg extended and other other knee can't extend down on table.
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what are the RF of developmental dysplasia of hip?
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female, breech, fam hx, first born w/ oligohydramniosis
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what is the ortolani test? what do you do if it is positive?
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hips start out- already has dislocated hip. elevation and abduction of femur relocates hip. if positive--> refer to ortho.
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what is the barlow test? what do you do if it is positive?
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dislocatable--> adduction and depression of femur dislocates the hip, if positive re-examine infant at 2 weeks, if positive again refer to ortho.
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what if the recheck on a positive barlow test comes up positive?
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Do a US at 4-6 weeks old and/or Xray at 3-5 mo
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what diagnostic tests do we do if we think it might be developmental dysplasia of the hip?
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ortolani test --- bigger problem
barlow test galeazzi test |
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what would you see on clinical inspection of a child with developmental dysplasia of the hip?
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accentuated skin folds on affected side anteriorly
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what is the Galeazzi test?
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knee on affected side is lower (hip dislocated posterior in supine position)
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T/F
septic hip is an acute surgical emergency |
true
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what are the sxs of septic hip?
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pain, decrease PROM/AROM
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at what WBC count do you aspirate a hip?
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>50,000
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what criteria are used on a septic hip to confirm septic arthritis (90%)?
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3 of the 4:
WBC< 12,000 ESR>40 inability to bear wt Fever >101.5 |
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what pathogens are to blame for septic hip for babies <12 months, kids 6-8 yrs, 8-12 yrs, and young adults 12-18 respectively?
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<12 months: staph, group B strep
6-8 yrs- Staph, H influenza 8-12- S. aureus 12-18- S. aureus, N gonorrhea |
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what is the tx for septic hip?
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irrigation and debridement
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what is the classic presentation of septic hip?
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flexed and externally rotated
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in age group is osteomyelitis more common in? why?
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children: richer metaphyseal blood flow, U turn at the growth plate --> seeding bony metaphysis, small aterioles
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what is the tx for osteomyelitis?
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IV antibiotics 4-6 wks
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what is the MC cause of painful hip in childhood? how do you diagnose this? causes?
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transient synovitis. Diagnosis of exclusion
causes: viral infection, allergy, trauma |
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which hip disorder/ infection has a ESR <20?
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Transient synovitis
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what is legg calve perthes? what age group is it common in? what causes it? what are the sxs?
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osteonecrosis of proximal femoral epiphysis, boys 4-8 yo. caused by Family history or low birth weight. Sxs: knee pain, effusion, limp, decreased ROM, esp abduction, internal rotation
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when is legg-calve-perthes associated with a poor prognosis?
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>6 yr w/ collapse
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what is a slipped capital femoral epiphysis? who is most common in? what will you see in examination? An increased risk in what disorder is associated with this?
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slippage of growth plate from weakness of perichondral ring; African american, obese and adolescent boys 10-16
exam: external rotation w/ flexion of hip increased risk of hypothyroidism |
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50% of hip fractures in the elderly is this type of fracture? why? how do you tx it?
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intertrochanteric--> usu unstable d/t to age (>65) and low bone density. Tx w/ surgery
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what is the main worry associated with subcapital femoral neck fracture? who is afflicted by this?
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destroy blood supply to the head of the femur which is why this is tx w/ surgery..
afflicted--> elderly |
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how do you tx trochanteric bursitis? who normally gets this and why?
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NSAIDs, cortisone in bursa, stretches. Women because their hips are wider.
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