Term
What is the most common cause of hip pain? |
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Definition
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Term
Pt with articular hip disease often complain of pain in the . . . |
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Definition
groin and anterior hip (inguinal) region |
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Term
Patients with articular hip disease often note symptoms are worse with ______________ |
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Definition
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Term
If range of motion is decreased due to articular hip pain, patients will describe difficulty _____________ or ___________ |
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Definition
tying their shoelaces walking up stairs |
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Term
In severe cases, patients will walk up stairs _________, using only the unaffected side to ascend or descend stairs. |
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Definition
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Term
LATERAL hip pain suggests extra-articular causes such as ____________ or ______________ |
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Definition
trochanteric bursitis tendonitis of hip ABductors |
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Term
Regarding hip pain, pain in the buttock suggests what ddx? |
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Definition
articular hip disease lumbosacral spine disease ischial bursitis vascular insufficiency |
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Term
What is considered in the differential for hip pain if the pain is described as DEEP? |
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Definition
renal colic psoas abscess PID osteitis pubis |
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Term
What is considered in the differential for hip pain if the pain is described as ANTERIOR/INGUINAL? |
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Definition
inguinal hernia iliopsoas bursitis renal colic vascular insufficiency |
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Term
What is considered in the differential for hip pain if the pain is described as LATERAL? |
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Definition
trochanteric bursitis tendonitis of the hip abductors lumbosacral spine disease meralgia paresthetica |
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Term
What is the cause of hip pain if symptoms include MORNING STIFFNESS (classically lasting for 1 hr) and IMPROVES WITH ACTIVITY? |
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Definition
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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? |
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Definition
degenerative disease (less commonly - vascular disease) |
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Term
Change in gait is associated with ________ and not found in __________ |
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Definition
found in hip problems not found in back problems |
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Term
The Straight leg raise maneuver is used to assess for . . . |
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Definition
irritation of the nerve roots (usually S1 or L5) such as with a herniated disc |
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Term
The Trendelenburg test assesses . . . |
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Definition
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Term
Pts with Meralgia Parestheticia with have . . . |
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Definition
Decreased or heightened sensation in the area of distribution of the lateral cutaneous nerve |
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Term
What area of the leg is innervated by the LATERAL CUTANEOUS NERVE? |
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Definition
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Term
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Definition
avascular necrosis of the femoral head |
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Term
If a pt has decreased flexion of the hip and difficulty with bending over to tie their shoes you should think . . . |
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Definition
osteoarthritis of the hip |
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Term
What range of motion is first affected by osteoarthritis? |
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Definition
INTERNAL ROTATION ABduction |
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Term
What is the management for osteoarthritis? |
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Definition
1. Pt ed, tylenol, EXERCISE, wt loss 2. low dose NSAIDs (Ibuprofen 400mg q6) 3. HIGH dose NSAIDs 4. referral for joint surgery |
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Term
With MERALGIA PARESTHETICA pain is worsened with . . . |
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Definition
hip EXTENSION (standing or sleeping) |
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Term
Will MERALGIA PARESTHETICA cause weakness? |
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Definition
NO, the LATERAL FEMORAL CUTANEOUS NERVE is senosory only. |
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Term
If a pt has symptoms of Meralgia Paresthetica, but has MOTOR WEAKNESS, what is the cause? |
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Definition
Lumbosacral spine disease |
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Term
A sense of joint instability ("giving out") or of the knee locking up is also suggestive of a significant ____________. |
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Definition
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Term
The Lachman Test assesses the ______ |
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Definition
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Term
The anterior draw test is used to assess the _______ |
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Definition
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Term
What is the The Lateral Pivot Shift Test? |
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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 |
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Term
The McMurray Test assesses the knee for a __________ |
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Definition
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Term
What is Patellofemoral Syndrome? |
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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 |
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Term
What ultimately causes Patellofemoral Syndrome? |
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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 |
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Term
When will pts typically complain of worsening pain with Patellofemoral Syndrome? |
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Definition
when they have been sitting for extended periods of time (moviegoer's sign) |
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Term
What relieves the pain of Patellofemoral Syndrome? |
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Definition
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Term
What is the tx for Patellofemoral Syndrome? |
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Definition
Treatment includes avoidance of precipitating activities, NSAIDs, and physical therapy. Physical therapy is aimed at quadriceps strengthening |
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Term
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Definition
Patellar tendonitis (this is differentiated from patellofemoral syndrome, because sitting does not make pain worse with this syndrome) |
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Term
LATERAL KNEE PAIN made worse with RUNNING |
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Definition
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Term
What is Iliotibial band syndrome? |
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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 |
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Term
What is the tx for Iliotibial band syndrome? |
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Definition
rest and NSAIDs; occasionally stretching exercises are useful |
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Term
What is ANSERINE BURSITIS? |
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Definition
The anserine bursa lies between the medial collateral ligament and the overlying tendons of the sartorius, gracilis and semitendinosus muscles |
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Term
Who gets Anserine Bursitis? |
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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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