Card Set Information
How do you determine the aggravating factors of the hip?
- likely direction of restricition
- movts the pt is avoiding
* pain intensity
* how quickly it comes on
* how quickly it eases
Area of pain for pts with hip problems?
- groin and lower back pain- need to think L2 (if pins and needles/ numbness- from lumbar spine)
- arthritic hips sometimes present with knee pain
- slipped femoral capepiphosis- boys 10-14 sometimes present with knee pain
What are some easing factors for those with hip problems?
- taking wieght off leg
- lying position of ease- on back
- movement- general movement
What are the aggravation factors for hip problems?
- crossing legs
- getting in and out of your car
- up and down stairs
- on/ off bicycle
- putting socks on
- starting to walk after period of immobility
Mechanical features of hip problems?
- stiff like heat
- worse activity
- daily pattern
- eases with rest
- short term stiffness in morning <1hr
- worse end of day- stiff
Joint- OA- stiffness
Inflammatory features of hip problems?
- antiinflammatory- RA- systemic- night pain, bilateral systems, other jts- chornic pain- likes heat
- Worse 1-2 hrs
Night pain for people with hip problems?
difficulty getting to sleep
best/ worse position
wake during the night eg moving
how long does it take to get back to sleep
pillows- easing factor
- tumor that sits in the middle of the back presents like a mm
- recent cold and flu- could be systemic
- general health
- unexplained weight loss
- past history of cancer
- FH (family history) of rheumatoid
- diabetes, heart problems
- kidney usually lower back
- urinary problems- usually can present groin
What is the 24hr behaviour?
- effect of rest
- morning stiffness > 30 min- inflam or OA hip
- activity levels
- eased with rest
What investigations for hip problems?
- Arthrogram-joint die, leaking
- Bone scan- whole body- hotspots- blood supply where it shouldnt
- screening for urogenital, intestinal function
History of hip problem pts?
- gradual or sudden
- overuse/ misuse- standing on one hip
- sudden eg twist on one leg, labral tear (soft cartilage- makes jt deeper), mm, lig tear
- history of LBP (lower back pain) 1st
-referred pain- hip only refers down