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Ortho Hip

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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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