583 hip

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  1. Hip conditions:
    Inflammation of bursae which may cause bursa to become painful
  2. A fluid-filled sac that functions as a gliding surface to reduce friction between tissues of the body
  3. pain is felt in the hip, particularly over the greater trochanter. This is the most commonly affected bursae of the hip. It may be particularly sore to sleep on the side of the affected hip.
    Trochanteric bursitis
  4. Pain is felt in the groin area. Pain may be felt on walking, particularly when the affected hip is extended leading to a
    shortening of the normal stride length to reduce the pain. Sometimes a mass may be felt resembling a hernia.  (Less common)
    Iliopsoas bursitis
  5. •Lateral hip, thigh or knee pain
    •Occasional snapping as ITB passes over the greater trochanter
    •Especially at lateral knee during
    running - if left untreated pain during walking or climbing stairs
    •Limitation in flexion, abduction & internal rotation
    Iliotibial band syndrome
  6. Intrinsic factors for which condition?
    1. Tightness in the iliotibialband.

    2. Myofascial restrictions in the hip and thigh musculature, which will increase tension on the band.

    3. Weakness in hip abductors, (common in distance runners).

    4.Weakness or poor control of knee muscles, especially the quads.
5. Dominance of anterior hip muscles, (TFL) over posterior hip muscles,(gluts).

    6. Excessively flat feet or high arches.

    7. Bow legs or knock-knees.

    8. Leg length inequality.

    9. Limited ankle range of motion.
    Iliotibial band syndrome
  7. Extrinsic factors for which condition?
    1. Training errors e.g. Excessive mileage, sudden increase in mileage, sudden increase in intensity of training
, too
    much hill work, running on crowded roads
    2. Over striding
3. Worn out running shoes
4. Failing to warm up or cool down properly
    Iliotibial band syndrome
  8. •Dull posterior pain that mimic sciatica
    •History of track competition or prolonged sitting
    •Limitation in flexion, abduction & internal rotation
    Piriformis syndrome
  9. •Neonatal instability of hip
    •Late-diagnosed developmental dislocation of the hip
    •5-9x more common in females
    •Familial tendency
    •Any factor that causes cramping of fetus inside the uterus
    •delivered in breech position
    Developmental Dysplasia of the Hip (DDH)
  10. How do you detect Developmental Dysplasia of the Hip?
    • Physical examination
    • Ultrasound imaging
    • X-ray (after 4 months)
    • Leg length discrepancy
    • Decreased ROM
    • Limping in toddlers
  11. How is DDH treated?
    • Some can spontaneously recover
    • Abduction splint/Pavlik harness
    • Surgery
  12. •Middle-aged/ elderly
    •Unknown cause
    •Progressive pain and stiffness
    Primary osteoarthritis (OA)
  13. •DDH
    •Congenital coxa valgus/vara
    •Perthes’ disease (blood supply to epiphysis of
    femoral head)
    •Tuberculous/ pyogenic infections
    •Avascular necrosis / fracture
    Progressive pain and stiffness
    Secondary OA
  14. Common at 4-6 years old
    Unknown cause but related to anteversion of femoral neck 
    Poor blood supply to femoral head 
    Legg-Calve-Perthes' disease
  15. What are 4 symptoms of OA Hip
    • 1. Poorly located at hip, groin, buttock or greater trochanter
    • 2. Referred pain to knee
    • 3. Increase with standing or walking
    • 4. Stiffness
  16. 2 types of surgery for OA Hip
    • 1. Hemiarthroplasty
    • 2. Total hip replacement
  17. Knee Large Q angle:
    Wearing down the upper side of patella
    Fibrillation of articular cartilage lining of patella ->PF
    Chondromalacia of knee
  18. True or false:
    Men are at higher risk for patellofemoral pain
    False. Women are at a higher risk.
  19. Knee condition:
    Often seen in young childrne, resolves spontaneously by age 6
    In adolescent girls causes recurrent dislocation of patella
    In adults bone softening & ligamentous stretching accompaning RA or paralytic disorders that cause ligament stretching/altered epiphyseal growth
    Genu valgum
  20. Hamstring tightness can cause this
    Patellofemoral joint pain
  21. Symptoms of this knee condition:
    •Give way
    •Quadriceps atrophy
    ACL Injury
  22. Is an isolated ACL injury usually treated surgically?
    No, unless there is bone avulsion
  23. What is common treatment for ACL injury?
    • Intense quad and hamstring strengthening
    • Ligament reconstruction
  24. Knee Conditions:
    What is O'Donoghue's triad composed of?
    • ACL
    • Medial meniscus
    • MCL
  25. Which knee condition:
    •Anteromedial rotatory (MCL)
    •Anterolateral rotatory (ACL)
    •Posterolateral rotatory (PCL, LCL)
    •Combination of all lesions
    Tibial subluxation (instability)
  26. Knee condition:
    •Twist strain in the flexed weight bearing leg
    •Trapped meniscus splits longitudinally (bucket handle tear)
    Meniscus injury
  27. The following are symptoms of which condition:
    •Locking of the knee
    •Springy block of full extension
    •Pain at the joint line
    Meniscus injury
  28. Which knee condition?
    •Large Q angle
    •Shallow Femoral sulcus 
    •Abnormal lateral insertion of quadriceps
    •Muscle imbalance
    •Lateral femoral condyle hypoplasia
    •Genu recurvatum
    Patella dislocation
  29. internal rotation of femur relative to tibia with knee in valgus & flexion
    Direct blow from the side while the foot is planted and femur rotated relative to the tibia
    High risk of redislocation (48%) if non-operated
    Patella dislocation
  30. •Anterior knee pain
    •Pain after walking downstairs, prolonged sitting, squat, get up from sitting
    •clicking, grinding sound
    •catching of patella
    •Mild swelling
    •VMO atrophy
    PFJ syndrome (patellofemoral joint)
  31. Knee condition:
    •Progressive articular change
    •Flaking off into the joint
    •Subarticular bone change
    •Exposing free nerve ending
    •Joint surface distortion 
    •Knee replacement surgery
    Osteoarthritis (OA)
Card Set:
583 hip
2012-12-15 18:01:04
583 hip

583 hip
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