Shared Flashcard Set

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Hip Injuries
N/A
48
Medical
Professional
11/19/2011

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Cards

Term
What is the most common strain/sprain in the hip?
Definition
groin pull
Term
What is the 2nd most common strain/sprain in the hip?
Definition
flexor tendon strain
Term
What needs to be ruled out with strains/sprains of the hip, especially if the patient denies injury?
Definition
hernia
Term
What is the treatment for strains and sprains at the hip?
Definition
rest, ice, gentle stretching as it heals
slowly return to activities as permitted

may include anti-inflammatories and acetominophen
Term
What is a hip pointer?
Definition
direct blow (contusion) to the anterior superior iliac spine
Term
What is the treatment for a hip pointer?
Definition
rest, ice, gentle stretching
gradually return to activities
anti-inflammatories and acetominophen
Term
What activities are hip pointers common in?
Definition
contact sports
falls
Term
What does a patient with greater tronchanteric bursitis complain of?
Definition
-pain at lateral aspect of their hip
-hurts to lie on that side of their body (sleeping)
-tender to palpation at greater tronchanter where bursa is located
Term
What is the treatment for greater tronchanteric bursitis?
Definition
-physical therapy
-ice
-stretching
-anti-inflammatories/acetominophen (no longer than a few weeks)
-steroid shot (AFTER acute phase)
Term
How long should you wait to give a steroid shot in a patient with greater tronchanteric bursitis?
Definition
6-8 weeks (most patient will improve with time and an injection may not be needed)
Term
What is a common complaint of older patients who have hip dysplasia?
Definition
groin pain
Term
What PE finding is common with hip dysplasia?
Definition
leg length discrepancy
Term
What are other names for hip dysplasia?
Definition
developmental dysplasia of the hip (DDH)
congenital dysplasia of the hip (CDH)
developmental dislocation of the hip
Term
What is hip dysplasia?
Definition
malalignment of the hip which predisposes the hip to abnormal function and over time the hip will wear out
Term
What occurs secondary to hip dysplasia and is usually the source of pain?
Definition
osteoarthritis of the hip
Term
What can be see on an x-ray in a patient with hip dysplasia that leads to the hip being easily displaced?
Definition
shallow socket
Term
What are conservative treatment options for hip dysplasia?
Definition
anti-inflammatories
physical therapy
steroid injections
Term
What are surgical treatment options for hip dysplasia?
Definition
arthroscopy (if no OA)
osteotomy (re-alignment of the joint)
total hip arthroplasty (hip replacement)
Term
What is the second most common joint affected by OA?
Definition
hip (knee is first)
Term
What disease do you need to be careful about when thinking about doing steroid shots?
Definition
diabetes (blood sugar needs to be under 140)
Term
What type of pain is common with OA of the hip?
Definition
pain in the groin that radiates to the knees
Term
What do you need to always check in an older patient complaining of knee pain and why?
Definition
their hips

many times the knee pain is referred pain from OA of their hips
Term
What type of hip rotation causes pain in a patient with OA?
Definition
internal
Term
What type of gait might be present in a patient with OA of the hip?
Definition
Trendelenberg (weakness of gluteus medius)
Term
What are common x-ray findings with hip OA?
Definition
subchondral cysts
osteophytes (bone spurs)
Term
What is the treatment for OA of the hip?
Definition
similar to OA of the knee

conservative (anti-inflammatories, PT, steroid shots)

surgery--total hip replacement (THA)
Term
What hip fracture predisposes someone to AVN of the hip?
Definition
femoral neck fracture
Term
What is an early sign of AVN of the hip?
Definition
crescent sign (fracture between the subchondral bone and necrotic bone)
Term
What condition is associated with a deep pain in the buttock?
Definition
AVN of the hip
Term
If an MRI is positive for AVN but the radiographs show no evidence of it, what might the patient benefit from?
Definition
core decompression surgery (may be able to avoid THA altogether)
Term
What is the ultimate treatment for AVN of the hip?
Definition
THA
Term
What age group is affected by slipped capital femoral epiphysis (SCFE)?
Definition
adolescents (primarily heavier ones)
Term
What happens with SCFE?
Definition
epiphyseal plate slides off the long bone of the femur (mataphysis), displacing the position of the femur
Term
What needs to be done at diagnosis of SCFE?
Definition
immediately put pt. non-weight bearing and refer to orthopedic surgeon

pt. needs surgery right away!
Term
What kind of gait do kids with SCFE usually present with?
Definition
leg externally rotated (less painful)
Term
What hip rotation will cause increased pain with SCFE?
Definition
internal
Term
If you suspect SCFE but do not have available x-rays, what should you do?
Definition
treat them as if they do have SCFE (non-weight bearing and referral to ortho)
Term
What is Legg-Calve-Perthes disease (LCP)?
Definition
idiopathic osteonecrosis of the capital femoral epiphysis of the femoral head (similar to AVN)
Term
What age group is affected by Legg-Calve-Perthes disease?
Definition
young (6-10)
Term
How is LCP generally treated if caught early?
Definition
conservatively
Term
With regard to Legg-Calve-Perthes disease, the younger the child, the _______ the results.
Definition
better
Term
What is the most common presenting symptoms of LCP disease?
Definition
limp
Term
A ______ in a child is ALWAYS abnormal.
Definition
limp
Term
LCP films may be _________ at first, just like with AVN>
Definition
negative
Term
If there is a high suspicion of LCP and the x-rays were normal, what should you do?
Definition
get MRI
Term
LCP is generally unilateral/bilateral.
Definition
unilateral
Term
What are the conservative treatments for LCP?
Definition
anti-inflammatories
physical therapy for ROM
crutches for non-weight bearing
bracing may allow healing
Term
What surgical option is available for a patient with LCP who does not heal conservatively?
Definition
osteotomy
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