Hip Anatomy and Pathologies

A patient presents with hip pain exacerbated by activity and relieved by rest, and radiography reveals joint space narrowing, osteophytes, and subchondral sclerosis. This presentation is MOST consistent with:

Which of the following ligaments is NOT primarily responsible for extra-articular stability of the hip joint?

A patient with a displaced intracapsular neck of femur fracture (Garden III) is physiologically young and active. Considering long-term outcomes and functional expectations, the MOST appropriate surgical management strategy would be:

In the Evans classification of intertrochanteric fractures, which type is characterized by a 3-part fracture with loss of posterolateral support and is considered UNSTABLE?

Which radiographic finding is MOST indicative of hip dysplasia in a 3-year-old child?

Avascular necrosis (AVN) is a potential complication following a neck of femur fracture. Which factor is LEAST likely to increase the risk of AVN?

In the context of hip arthroplasty, 'cement disease' primarily refers to complications arising from:

Which of the following statements regarding subtrochanteric fractures is TRUE?

The 'sourcil' line in hip radiography is used to assess:

In the integrated care pathway for hip fractures, which of the following pre-hospital interventions is considered MOST critical in the immediate management?

The FIRST trial on femoroacetabular impingement (FAI) surgery primarily demonstrated:

A patient undergoing cemented hip arthroplasty experiences a sudden drop in blood pressure immediately after cement insertion. This is MOST likely due to:

Which surgical approach to the hip joint is generally considered to have the HIGHEST risk of postoperative hip dislocation?

In the management of slipped upper femoral epiphysis (SUFE), 'in-situ pinning' primarily aims to:

According to the Irish Hip Fracture Database 2018, approximately what percentage of patients with hip fractures were discharged directly home?

What is the MOST common presenting symptom of osteoarthritis of the hip?

The term 'femoral calcar' is clinically significant in intertrochanteric fractures because it:

In developmental dysplasia of the hip (DDH), diagnosis after 6 months of age typically shifts from ultrasound to X-ray because:

Which of the following is NOT a recognized risk factor for developmental dysplasia of the hip (DDH)?

The Tonnis angle, used in radiographic assessment of hip dysplasia, measures the angle between a horizontal line connecting the femoral head centers and a line through the:

In the context of femoroacetabular impingement (FAI), a 'CAM' deformity primarily refers to an abnormality of the:

Which imaging modality is considered the 'study of choice' for assessing avascular necrosis (AVN) of the femoral head?

A patient with rheumatoid arthritis of the hip is MOST likely to exhibit which radiographic feature?

In managing displaced intracapsular neck of femur fractures in elderly patients, hemiarthroplasty is often preferred over total hip replacement in which specific scenario?

The 'ligamentum teres' of the hip joint primarily contributes to:

Which of the following intraoperative complications of hip arthroplasty is MOST directly related to the surgical approach rather than implant-related factors?

According to BOA Blue Book Guidelines for hip fracture management, medically stable patients should ideally undergo surgery within:

In the management of undisplaced intracapsular neck of femur fractures (Garden I & II), the PRIMARY goal of fixation with cannulation screws is:

The term 'heterotopic ossification' as a complication of hip arthroplasty refers to:

Which type of hip fracture is MOST likely to realistically threaten the overlying skin due to its anatomical location and fracture pattern?

The 'Shenton's line' is assessed on hip radiographs to evaluate for:

In the context of hip arthroscopy for femoroacetabular impingement (FAI), better outcomes are MOST strongly correlated with the:

Which of the following is NOT a typical radiographic feature of osteoarthritis of the hip?

In slipped upper femoral epiphysis (SUFE), the slippage of the metaphysis is relative to the:

What is the reported overall rate of any complication within 90 days following total hip arthroplasty?

Which of the following surgical options is MOST commonly used for displaced subtrochanteric fractures to provide stable fixation and allow for early mobilization?

In the context of total hip arthroplasty bearing surfaces, 'metal-on-metal' articulations have been historically associated with increased risk of:

A FABER test assesses for pathology at the:

Which of the following is NOT a recommended initial management strategy for osteoarthritis of the hip?

In Evans classification, Type R intertrochanteric fracture refers to:

The primary blood supply to the femoral head is derived from branches of the:

A 70-year-old patient with a history of osteoarthritis is scheduled for a total hip arthroplasty. Preoperative templating suggests a femoral stem size that is borderline between two sizes. Which intraoperative factor should MOST strongly guide the final decision on femoral stem size?

In the context of hip osteoarthritis management, a patient reports adequate pain relief with NSAIDs but is concerned about potential long-term gastrointestinal side effects. Which of the following strategies represents the MOST appropriate next step in their management?

A patient is diagnosed with a Grade III slipped capital femoral epiphysis (SCFE). Considering the risk of avascular necrosis (AVN) and chondrolysis, what is the MOST critical factor in surgical management to minimize these complications?

A young, active patient presents with anterior hip pain, exacerbated by hip flexion and internal rotation. Radiographs are normal. An MRI arthrogram reveals a labral tear and mild articular cartilage damage. Considering the FIRST trial outcomes, what is the MOST accurate statement regarding the expected benefit of hip arthroscopy for this patient?

In the management of a displaced intracapsular neck of femur fracture in an 85-year-old patient with significant cognitive impairment and low functional demand, which surgical option is MOST appropriate to minimize operative time and post-operative complications?

During a posterior approach total hip arthroplasty, the surgeon encounters significant soft tissue contracture, making acetabular exposure challenging. Which surgical maneuver is LEAST likely to improve acetabular visualization and access in this situation?

A patient presents with groin pain and limited hip internal rotation. The FADIR test is positive. While considering femoroacetabular impingement (FAI), which of the following clinical findings would MOST strongly suggest a CAM deformity as the predominant morphology?

In the context of developmental dysplasia of the hip (DDH), why is ultrasound considered the primary imaging modality for infants younger than 6 months, while radiography becomes more relevant after 6 months?

Following a motor vehicle accident, a patient presents with posterior hip dislocation. After successful closed reduction, which of the following post-reduction management strategies is MOST crucial in preventing recurrent instability in the immediate post-injury period?

A 55-year-old patient with symptomatic hip osteoarthritis, refractory to conservative treatment, is being considered for total hip arthroplasty. Which of the following factors is the STRONGEST contraindication to proceeding with a cemented total hip arthroplasty?

In the Evans classification of intertrochanteric fractures, a Type IV fracture is described as a 3-part fracture with loss of medial support. Which anatomical structure is MOST critically involved in defining the 'medial support' in this classification?

A patient who underwent uncemented total hip arthroplasty 10 years ago presents with new onset groin pain and a progressive limp. Radiographs show no obvious loosening but there is subtle periarticular osteolysis. Which bearing surface combination is MOST likely to be implicated in this scenario?

During the initial pre-hospital management of a suspected hip fracture in an elderly patient, which intervention is of HIGHEST priority in optimizing patient outcomes according to integrated care pathways?

A patient is being evaluated for hip pain. The FABER test is positive. While this test is suggestive of hip pathology, it is MOST sensitive for identifying pathology in which anatomical region?

In the management of undisplaced Garden I intracapsular neck of femur fractures, fixation with cannulated screws is the standard treatment. What is the PRIMARY biomechanical goal of this fixation technique?

A patient develops heterotopic ossification (HO) following a total hip arthroplasty performed via a posterior approach. Which of the following factors is LEAST likely to be a significant risk factor contributing to the development of HO in this patient?

The 'Shenton's line' is a radiographic landmark assessed in hip radiographs. Disruption of Shenton's line is MOST indicative of:

In the context of hip arthroscopy for FAI, which patient characteristic is MOST strongly associated with better postoperative outcomes and return to pre-injury activity levels?

Which radiographic feature is LEAST consistent with a diagnosis of osteoarthritis of the hip?

In slipped upper femoral epiphysis (SUFE), the 'slippage' anatomically refers to the displacement of the:

What is the approximate overall reported rate of any complication within 90 days following total hip arthroplasty, based on epidemiological studies?

For displaced subtrochanteric fractures, which surgical fixation method is GENERALLY preferred due to its biomechanical advantages in providing stable fixation and allowing for early weight-bearing?

Historically, 'metal-on-metal' bearing surfaces in total hip arthroplasty were associated with a higher incidence of:

Which of the following is NOT considered a recommended initial non-operative management strategy for symptomatic osteoarthritis of the hip?

In the Evans classification of intertrochanteric fractures, what does a 'Type R' fracture specifically denote?

The PRIMARY blood supply to the femoral head, especially relevant in intracapsular neck of femur fractures and avascular necrosis, is derived from branches of the:

According to the Irish Hip Fracture Database 2018, approximately what percentage of patients with hip fractures were discharged directly home following their hospital stay?

In developmental dysplasia of the hip (DDH), a Tonnis angle greater than 10 degrees on pelvic radiographs in an older child is indicative of:

In femoroacetabular impingement (FAI), a 'CAM' deformity is best described as:

Which imaging modality is considered the 'study of choice' for the early and sensitive detection of avascular necrosis (AVN) of the femoral head, especially before radiographic changes are apparent?

In patients with rheumatoid arthritis affecting the hip, which radiographic finding is MOST characteristic and helps differentiate it from osteoarthritis?

In managing displaced intracapsular neck of femur fractures in frail elderly patients with limited life expectancy (<5 years), hemiarthroplasty is often favored over total hip arthroplasty primarily due to:

The ligamentum teres of the hip joint, while intra-articular, is considered to provide MINIMAL contribution to overall hip joint stability in adults. However, it does play a more significant role in:

Which intraoperative complication of hip arthroplasty is MOST directly linked to the surgical approach itself, rather than implant-related factors or patient-specific comorbidities?

According to BOA Blue Book Guidelines for hip fracture management, in medically stable patients, surgical intervention should ideally occur within:

The term 'heterotopic ossification' (HO), a potential complication of hip arthroplasty, refers to:

Which type of hip fracture is MOST likely to realistically pose a threat to the overlying skin due to its anatomical location and fracture pattern?

A 60-year-old patient, previously managed for hip osteoarthritis with NSAIDs and physiotherapy, reports a sudden increase in groin pain after a minor fall. Radiographs reveal no acute fracture, but demonstrate significant joint space narrowing and large osteophytes compared to previous imaging. The MOST appropriate next step in managing this patient's pain and functional limitation is:

In the context of hip biomechanics, the ligamentum teres is often considered to have a limited role in adult hip joint stability. However, in certain clinical scenarios, its integrity becomes particularly relevant. Which of the following situations would MOST significantly highlight the clinical importance of the ligamentum teres?

A 35-year-old male patient, with no history of trauma, presents with insidious onset anterior hip pain, exacerbated by prolonged sitting and hip flexion. Clinical examination reveals restricted internal rotation and a positive FADIR test. Initial radiographs are normal. Considering the etiology of femoroacetabular impingement (FAI), which underlying anatomical variant is LEAST likely to be the primary contributor to his symptoms?

In the management of a displaced intracapsular neck of femur fracture (Garden III or IV) in a frail 90-year-old patient with significant comorbidities and limited mobility, which surgical strategy is MOST appropriate to prioritize minimizing surgical duration and postoperative rehabilitation burden?

Following a total hip arthroplasty using a posterior surgical approach, a patient is noted to have persistent weakness in hip abduction and Trendelenburg gait. Which of the following intraoperative factors is MOST likely to be the direct cause of this complication?

A 14-year-old obese male presents with chronic left hip and thigh pain, worsening with activity. Examination reveals limited hip internal rotation and an externally rotated leg in resting position. Radiographs show widening of the proximal femoral physis and metaphyseal blurring. In managing this patient's condition (Slipped Upper Femoral Epiphysis - SUFE), what is the PRIMARY objective of 'in-situ' pinning?

In the Evans classification of intertrochanteric fractures, the concept of 'femoral calcar' integrity is crucial for determining fracture stability. A Type IV fracture, defined by loss of medial support, directly implicates which aspect of the femoral calcar?

A patient undergoing cemented total hip arthroplasty experiences a transient but significant episode of hypotension immediately following cement insertion. Which pathophysiological mechanism is MOST directly responsible for this intraoperative complication?

In the radiographic assessment of developmental dysplasia of the hip (DDH) in a 9-month-old infant, the 'sourcil' line is evaluated. What anatomical landmark defines the 'sourcil' and what clinical significance does its assessment hold?

A patient with rheumatoid arthritis affecting the hip joint is being evaluated for total hip arthroplasty. Which radiographic feature is MOST likely to be prominent in this patient, distinguishing rheumatoid arthritis from primary osteoarthritis of the hip?

In managing a 6-year-old child diagnosed with developmental dysplasia of the hip (DDH), a Tonnis angle of 15 degrees is measured on pelvic radiographs. What is the MOST accurate interpretation of this finding in the context of DDH assessment?

For a young, active patient undergoing hip arthroscopy for femoroacetabular impingement (FAI) with labral repair and chondroplasty, which factor is MOST strongly correlated with achieving better long-term outcomes and a successful return to pre-injury activity levels?

Following a motor vehicle accident, a patient presents with a posterior hip dislocation. After successful closed reduction in the emergency department, what is the MOST critical immediate next step in management to prevent early complications and optimize long-term outcomes?

In the context of total hip arthroplasty bearing surfaces, 'metal-on-metal' articulations were historically used but have fallen out of favor due to specific complications. Which of the following complications is MOST strongly associated with metal-on-metal hip replacements?

The FABER (Flexion, ABduction, External Rotation) test is commonly used in clinical examination of the hip. While a positive FABER test suggests hip joint pathology, it is MOST sensitive for identifying pathology in which specific anatomical location?

In the integrated care pathway for hip fractures, pre-hospital interventions are crucial. Which of the following pre-hospital interventions is considered MOST critical in the IMMEDIATE management of a patient with a suspected hip fracture?

In the context of developmental dysplasia of the hip (DDH), why is ultrasound considered the primary imaging modality for infants younger than 6 months, while radiography becomes more relevant after 6 months of age?

What is the approximate reported overall rate of ANY complication within 90 days following total hip arthroplasty, based on epidemiological studies?