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Johns Hopkins Hip and Knee
Johns Hopkins Hip and Knee
40
Medical
Graduate
04/05/2014

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Cards

Term
What is the most common cause of hip pain?
Definition
degenerative arthritis
Term
Pt with articular hip disease often complain of pain in the . . .
Definition
groin and anterior hip (inguinal) region
Term
Patients with articular hip disease often note symptoms are worse with ______________
Definition
weight bearing
Term
If range of motion is decreased due to articular hip pain, patients will describe difficulty _____________ or ___________
Definition
tying their shoelaces
walking up stairs
Term
In severe cases, patients will walk up stairs _________, using only the unaffected side to ascend or descend stairs.
Definition
sideways
Term
LATERAL hip pain suggests extra-articular causes such as ____________ or ______________
Definition
trochanteric bursitis
tendonitis of hip ABductors
Term
Regarding hip pain, pain in the buttock suggests what ddx?
Definition
articular hip disease
lumbosacral spine disease
ischial bursitis
vascular insufficiency
Term
What is considered in the differential for hip pain if the pain is described as DEEP?
Definition
renal colic
psoas abscess
PID
osteitis pubis
Term
What is considered in the differential for hip pain if the pain is described as ANTERIOR/INGUINAL?
Definition
inguinal hernia
iliopsoas bursitis
renal colic
vascular insufficiency
Term
What is considered in the differential for hip pain if the pain is described as LATERAL?
Definition
trochanteric bursitis
tendonitis of the hip abductors
lumbosacral spine disease
meralgia paresthetica
Term
What is the cause of hip pain if symptoms include MORNING STIFFNESS (classically lasting for 1 hr) and IMPROVES WITH ACTIVITY?
Definition
inflammatory disorders
Term
What is the cause of hip pain if pain is IMPROVED WITH REST, WORSE WITH ACTIVITY, and WORSE AT THE END OF THE DAY?
Definition
degenerative disease
(less commonly - vascular disease)
Term
Change in gait is associated with ________ and not found in __________
Definition
found in hip problems
not found in back problems
Term
The Straight leg raise maneuver is used to assess for . . .
Definition
irritation of the nerve roots (usually S1 or L5) such as with a herniated disc
Term
The Trendelenburg test assesses . . .
Definition
hip ABduction strength
Term
Pts with Meralgia Parestheticia with have . . .
Definition
Decreased or heightened sensation in the area of distribution of the lateral cutaneous nerve
Term
What area of the leg is innervated by the LATERAL CUTANEOUS NERVE?
Definition
anterolateral
Term
What is Perthes disease?
Definition
avascular necrosis of the femoral head
Term
If a pt has decreased flexion of the hip and difficulty with bending over to tie their shoes you should think . . .
Definition
osteoarthritis of the hip
Term
What range of motion is first affected by osteoarthritis?
Definition
INTERNAL ROTATION
ABduction
Term
What is the management for osteoarthritis?
Definition
1. Pt ed, tylenol, EXERCISE, wt loss
2. low dose NSAIDs (Ibuprofen 400mg q6)
3. HIGH dose NSAIDs
4. referral for joint surgery
Term
With MERALGIA PARESTHETICA pain is worsened with . . .
Definition
hip EXTENSION
(standing or sleeping)
Term
Will MERALGIA PARESTHETICA cause weakness?
Definition
NO, the LATERAL FEMORAL CUTANEOUS NERVE is senosory only.
Term
If a pt has symptoms of Meralgia Paresthetica, but has MOTOR WEAKNESS, what is the cause?
Definition
Lumbosacral spine disease
Term
A sense of joint instability ("giving out") or of the knee locking up is also suggestive of a significant ____________.
Definition
ligament injury
Term
The Lachman Test assesses the ______
Definition
ACL
Term
The anterior draw test is used to assess the _______
Definition
ACL
Term
What is the The Lateral Pivot Shift Test?
Definition
used to test ACL. the knee rotates slightly as it is extended, screwing into place with full extension. The ACL provides the force for this rotation, and the Lateral Pivot Shift Test assesses this rotation as the knee is extended
Term
The McMurray Test assesses the knee for a __________
Definition
torn meniscus
Term
What is Patellofemoral Syndrome?
Definition
Patellofemoral syndrome refers to a group of disorders that result in knee pain, which are due to either abnormality in the patellofemoral alignment, surrounding soft tissues, or leg malalignment relative to the thigh
Term
What ultimately causes Patellofemoral Syndrome?
Definition
extension of the knee will result in repetitive injury as the patella tracks abnormally. Because knee extension (and contraction of the quadriceps muscles) results in this injury, precipitating activities include running, jumping, ascending or descending stairs, and squatting
Term
When will pts typically complain of worsening pain with Patellofemoral Syndrome?
Definition
when they have been sitting for extended periods of time (moviegoer's sign)
Term
What relieves the pain of Patellofemoral Syndrome?
Definition
extension of the leg
Term
What is the tx for Patellofemoral Syndrome?
Definition
Treatment includes avoidance of precipitating activities, NSAIDs, and physical therapy. Physical therapy is aimed at quadriceps strengthening
Term
What is JUMPER'S KNEE?
Definition
Patellar tendonitis (this is differentiated from patellofemoral syndrome, because sitting does not make pain worse with this syndrome)
Term
LATERAL KNEE PAIN made worse with RUNNING
Definition
Iliotibial band syndrome
Term
What is Iliotibial band syndrome?
Definition
also known as runner's knee, results from friction as the iliotibial band runs over the lateral femoral condyle. Both running and cycling are risk factors for the development of iliotibial band syndrome, which is also seen in military personnel who do a lot of marching
Term
What is the tx for Iliotibial band syndrome?
Definition
rest and NSAIDs; occasionally stretching exercises are useful
Term
What is ANSERINE BURSITIS?
Definition
The anserine bursa lies between the medial collateral ligament and the overlying tendons of the sartorius, gracilis and semitendinosus muscles
Term
Who gets Anserine Bursitis?
Definition
Swimmers and runners may develop anserine bursitis due to repetitive injury, and present with pain and tenderness over the medial aspect of the upper tibia
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