66 Questions
What does a wide-based gait indicate?
Cerebellar disease or peripheral neuropathy
Which muscle weakness leads to a steppage gait?
Tibialis anterior
What causes a patient to push on the thigh with the hand to try to lock the knee in stance phase?
Quadriceps weakness
Which gait is associated with weak ankle dorsiflexors?
Flat foot gait
What does a patient with foot drop experience?
Weakness of tibialis anterior
What does it suggest if during the Trendelenburg test, the pelvis on the unsupported side drops significantly compared to the supported side?
Gluteus medius weakness
During the Thomas test, what does it suggest if the thigh of the leg hanging freely remains flat against the table?
Normal hip flexor length
What could be a consequence of tight hip flexor muscles identified through the Thomas test?
Altered gait mechanics
If a patient demonstrates significant pelvic tilt during the Trendelenburg test, which muscle is likely affected?
Gluteus medius muscle
During the Ober test, what position is the unaffected side in?
Facing upward
What does it indicate if the thigh remains in abduction or cannot adduct past the horizontal position during the Ober test?
IT band tightness
What does the Trendelenburg test assess?
Hip abductor muscles
A noticeable lean or shift of the torso away from the painful side during walking, helping to offload weight from the affected leg
Antalgic gait
What is the most common mechanism of injury that causes pelvic fractures?
Car accidents
How is a hip reduction typically performed in the emergency room?
Flexion of the hip to 90 degrees, adduction, and internal rotation
What is a common risk factor associated with hip fractures due to length of bed rest, especially if not repaired?
Pulmonary embolisms and pneumonia
Which type of femoral neck fracture involves complete fracture without displacement of the femur head?
Garden Type Two
What is the recommended repair approach for intertrochanteric fractures of the femur?
ORIF with plates or screws
What do femoral shaft fractures require for repair?
Closed reduction with nail placement
Which diagnostic tool is recommended for assessing pelvic fractures?
CT scan
What is a common risk factor associated the common etiologies of hip fractures in elderly patients?
Falls
What condition is at increased risk for avascular necrosis?
Hip Fractures
How is a distal femur fracture typically repaired?
Open reduction with internal fixation (ORIF) using plates or screws
What is the most common type of hip dislocation?
Posterior
How is a hip dislocation typically treated?
Hospital with anesthesia and reduction
What is the Garden Type Two femoral neck fracture characterized by?
Complete without head displacement
What procedure is typically required for a Garden Type Four femoral neck fracture?
Total hip replacement or Hemiarthroplasty
What is a defining characteristic of pelvic fractures?
Presence of multiple fractures due to ring shape structure
a femur head fracture that is incomplete with valgus impaction, and will need to be repaired with open reduction with internal fixation with screws
garden type 1
complete fracture with total displacement of the femur head, is a garden class
4
Hip dislocations are not common due to stability of the hip joint, but a hip dislocation will require reduction in the emergency room while the patient is under anesthesia
True
Hip fracture occur in patients older than 65 years of age likely due to a fall
True
Garden Type ___ is a femur head fracture that is incomplete with valgus impaction, and will need to be repaired with open reduction with internal fixation with screws
1
What is the conservative, first-line treatment for a labral tear of the hip?
NSAIDs, rest, and PT
What is a common symptom reported by a patient with hip osteoarthritis?
Aching pain over the anterior groin and thigh
Which imaging modality is used for diagnosing a labral tear of the hip?
MRI arthrogram
Why might a patient with femoral acetabular impingement experience pain in the groin after sitting or walking?
As a result of osseous deformities on the acetabular rim and femoral head
What is the definitive treatment for osteoarthritis of the hip?
Hip replacement
What is the common finding in athletes associated with femoral acetabular impingement?
Pain in the groin
Which is a likely symptom experienced by a patient with a labral tear of the hip?
Locking, clicking, and stiffness in the hip
What is the definitive treatment for osteoarthritis of the hip?
Hip replacement surgery
What characteristic symptom is commonly reported by patients with femoral acetabular impingement?
Aching pain over the anterior groin and thigh
Hip impingement, known as femoral acetabular impingement, can be developed in patients or could be a condition that a patient was born with
True
A patient with femoral acetabular impingement will have
decreased hip flexion that progressively worsens
The conservative, first line, treatment for femoral acetabular impingement AND labral tears of the hip are NSAIDs, rest and PT, but if this fails, hip arthroscopy may be necessary
True
A labral tear of the hip is most commonly due to overuse, trauma, or femoral acetabular impingement
True
A patient with hip ________ will unlikely be able to cross their legs due to the loss of range of motion in their hips
osteoarthritis
When it comes to OA of the hip, the patient can use NSAIDs and intraarticular injection for pain control until ready for a hip replacement. Where are the intraarticular injections preformed?
with radiology
What is the diagnostic gold standard for avascular necrosis of the hip?
MRI
Which of the following is NOT a common causative agent of septic joint?
Group B streptococcus
What is the conservative treatment for a patient with Slipped Capital Femoral Epiphysis (SCFE)?
Non-weight bearing rest
What surgical repair option is NOT typically used for avascular necrosis of the hip?
Arthroscopic surgery
What is a distinguishing feature of a pulled groin injury?
Pain at the origin of the adductor muscles
What symptom may indicate a patient has Slipped Capital Femoral Epiphysis (SCFE)?
Limited internal rotation, flexion, and abduction
What is not a potential cause of avascular necrosis of the hip
Tibial fracture
Slipped Capital Femoral Epiphysis (SCFE) is most common in:
obese, prepubescent boys
The most common causative agent of osteomyelitis is:
group A strep or staph aureus
Avascular necrosis of the hip can lead to bone tissue death due to the lack of blood supply, which will ultimately cause:
advanced osteoarthritis
Septic joint and osteomyelitis both require IV antibiotics with cleaning out the impacted area
True
What is a common presenting symptom of trochanteric bursitis in patients?
Pain at night when lying on the affected side
Which test would likely be positive in a patient with external snapping hip?
Ober test
What treatment approach is recommended for internal snapping hip due to iliopsoas tendon snapping?
Rest, ice, and physical therapy for stretching
What structure causes snapping in external snapping hip syndrome?
IT band snapping over the iliopectineal eminence
Which of the following is a common treatment recommendation for trochanteric bursitis?
Stretching and pain management
A patient with INTERNAL snapping hip will report groin pain when standing up from a seated position
True
A patient with INTERNAL snapping hip will have pain with resisted hip flexion
True
Explore key points about various gait abnormalities observed during a hip examination, such as wide-based gait, antalgic gait, steppage gait, and more. Understand the implications of these abnormalities in diagnosing conditions like instability, pain, and weakness.
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