Podcast
Questions and Answers
What does a wide-based gait indicate?
What does a wide-based gait indicate?
- Back pain
- Hip instability
- Muscle weakness
- Cerebellar disease or peripheral neuropathy (correct)
Which muscle weakness leads to a steppage gait?
Which muscle weakness leads to a steppage gait?
- Gluteus medius
- Tibialis anterior (correct)
- Quadriceps
- Gastrocnemius
What causes a patient to push on the thigh with the hand to try to lock the knee in stance phase?
What causes a patient to push on the thigh with the hand to try to lock the knee in stance phase?
- Gluteus maximus weakness
- Gluteus medius weakness
- Gastrocnemius weakness
- Quadriceps weakness (correct)
Which gait is associated with weak ankle dorsiflexors?
Which gait is associated with weak ankle dorsiflexors?
What does a patient with foot drop experience?
What does a patient with foot drop experience?
What does it suggest if during the Trendelenburg test, the pelvis on the unsupported side drops significantly compared to the supported side?
What does it suggest if during the Trendelenburg test, the pelvis on the unsupported side drops significantly compared to the supported side?
During the Thomas test, what does it suggest if the thigh of the leg hanging freely remains flat against the table?
During the Thomas test, what does it suggest if the thigh of the leg hanging freely remains flat against the table?
What could be a consequence of tight hip flexor muscles identified through the Thomas test?
What could be a consequence of tight hip flexor muscles identified through the Thomas test?
If a patient demonstrates significant pelvic tilt during the Trendelenburg test, which muscle is likely affected?
If a patient demonstrates significant pelvic tilt during the Trendelenburg test, which muscle is likely affected?
During the Ober test, what position is the unaffected side in?
During the Ober test, what position is the unaffected side in?
What does it indicate if the thigh remains in abduction or cannot adduct past the horizontal position during the Ober test?
What does it indicate if the thigh remains in abduction or cannot adduct past the horizontal position during the Ober test?
What does the Trendelenburg test assess?
What does the Trendelenburg test assess?
A noticeable lean or shift of the torso away from the painful side during walking, helping to offload weight from the affected leg
A noticeable lean or shift of the torso away from the painful side during walking, helping to offload weight from the affected leg
What is the most common mechanism of injury that causes pelvic fractures?
What is the most common mechanism of injury that causes pelvic fractures?
How is a hip reduction typically performed in the emergency room?
How is a hip reduction typically performed in the emergency room?
What is a common risk factor associated with hip fractures due to length of bed rest, especially if not repaired?
What is a common risk factor associated with hip fractures due to length of bed rest, especially if not repaired?
Which type of femoral neck fracture involves complete fracture without displacement of the femur head?
Which type of femoral neck fracture involves complete fracture without displacement of the femur head?
What is the recommended repair approach for intertrochanteric fractures of the femur?
What is the recommended repair approach for intertrochanteric fractures of the femur?
What do femoral shaft fractures require for repair?
What do femoral shaft fractures require for repair?
Which diagnostic tool is recommended for assessing pelvic fractures?
Which diagnostic tool is recommended for assessing pelvic fractures?
What is a common risk factor associated the common etiologies of hip fractures in elderly patients?
What is a common risk factor associated the common etiologies of hip fractures in elderly patients?
What condition is at increased risk for avascular necrosis?
What condition is at increased risk for avascular necrosis?
How is a distal femur fracture typically repaired?
How is a distal femur fracture typically repaired?
What is the most common type of hip dislocation?
What is the most common type of hip dislocation?
How is a hip dislocation typically treated?
How is a hip dislocation typically treated?
What is the Garden Type Two femoral neck fracture characterized by?
What is the Garden Type Two femoral neck fracture characterized by?
What procedure is typically required for a Garden Type Four femoral neck fracture?
What procedure is typically required for a Garden Type Four femoral neck fracture?
What is a defining characteristic of pelvic fractures?
What is a defining characteristic of pelvic fractures?
a femur head fracture that is incomplete with valgus impaction, and will need to be repaired with open reduction with internal fixation with screws
a femur head fracture that is incomplete with valgus impaction, and will need to be repaired with open reduction with internal fixation with screws
complete fracture with total displacement of the femur head, is a garden class
complete fracture with total displacement of the femur head, is a garden class
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
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
Hip fracture occur in patients older than 65 years of age likely due to a fall
Hip fracture occur in patients older than 65 years of age likely due to a fall
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
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
What is the conservative, first-line treatment for a labral tear of the hip?
What is the conservative, first-line treatment for a labral tear of the hip?
What is a common symptom reported by a patient with hip osteoarthritis?
What is a common symptom reported by a patient with hip osteoarthritis?
Which imaging modality is used for diagnosing a labral tear of the hip?
Which imaging modality is used for diagnosing a labral tear of the hip?
Why might a patient with femoral acetabular impingement experience pain in the groin after sitting or walking?
Why might a patient with femoral acetabular impingement experience pain in the groin after sitting or walking?
What is the definitive treatment for osteoarthritis of the hip?
What is the definitive treatment for osteoarthritis of the hip?
What is the common finding in athletes associated with femoral acetabular impingement?
What is the common finding in athletes associated with femoral acetabular impingement?
Which is a likely symptom experienced by a patient with a labral tear of the hip?
Which is a likely symptom experienced by a patient with a labral tear of the hip?
What is the definitive treatment for osteoarthritis of the hip?
What is the definitive treatment for osteoarthritis of the hip?
What characteristic symptom is commonly reported by patients with femoral acetabular impingement?
What characteristic symptom is commonly reported by patients with femoral acetabular impingement?
Hip impingement, known as femoral acetabular impingement, can be developed in patients or could be a condition that a patient was born with
Hip impingement, known as femoral acetabular impingement, can be developed in patients or could be a condition that a patient was born with
A patient with femoral acetabular impingement will have
A patient with femoral acetabular impingement will have
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
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
A labral tear of the hip is most commonly due to overuse, trauma, or femoral acetabular impingement
A labral tear of the hip is most commonly due to overuse, trauma, or femoral acetabular impingement
A patient with hip ________ will unlikely be able to cross their legs due to the loss of range of motion in their hips
A patient with hip ________ will unlikely be able to cross their legs due to the loss of range of motion in their hips
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?
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?
What is the diagnostic gold standard for avascular necrosis of the hip?
What is the diagnostic gold standard for avascular necrosis of the hip?
Which of the following is NOT a common causative agent of septic joint?
Which of the following is NOT a common causative agent of septic joint?
What is the conservative treatment for a patient with Slipped Capital Femoral Epiphysis (SCFE)?
What is the conservative treatment for a patient with Slipped Capital Femoral Epiphysis (SCFE)?
What surgical repair option is NOT typically used for avascular necrosis of the hip?
What surgical repair option is NOT typically used for avascular necrosis of the hip?
What is a distinguishing feature of a pulled groin injury?
What is a distinguishing feature of a pulled groin injury?
What symptom may indicate a patient has Slipped Capital Femoral Epiphysis (SCFE)?
What symptom may indicate a patient has Slipped Capital Femoral Epiphysis (SCFE)?
What is not a potential cause of avascular necrosis of the hip
What is not a potential cause of avascular necrosis of the hip
Slipped Capital Femoral Epiphysis (SCFE) is most common in:
Slipped Capital Femoral Epiphysis (SCFE) is most common in:
The most common causative agent of osteomyelitis is:
The most common causative agent of osteomyelitis is:
Avascular necrosis of the hip can lead to bone tissue death due to the lack of blood supply, which will ultimately cause:
Avascular necrosis of the hip can lead to bone tissue death due to the lack of blood supply, which will ultimately cause:
Septic joint and osteomyelitis both require IV antibiotics with cleaning out the impacted area
Septic joint and osteomyelitis both require IV antibiotics with cleaning out the impacted area
What is a common presenting symptom of trochanteric bursitis in patients?
What is a common presenting symptom of trochanteric bursitis in patients?
Which test would likely be positive in a patient with external snapping hip?
Which test would likely be positive in a patient with external snapping hip?
What treatment approach is recommended for internal snapping hip due to iliopsoas tendon snapping?
What treatment approach is recommended for internal snapping hip due to iliopsoas tendon snapping?
What structure causes snapping in external snapping hip syndrome?
What structure causes snapping in external snapping hip syndrome?
Which of the following is a common treatment recommendation for trochanteric bursitis?
Which of the following is a common treatment recommendation for trochanteric bursitis?
A patient with INTERNAL snapping hip will report groin pain when standing up from a seated position
A patient with INTERNAL snapping hip will report groin pain when standing up from a seated position
A patient with INTERNAL snapping hip will have pain with resisted hip flexion
A patient with INTERNAL snapping hip will have pain with resisted hip flexion
Flashcards
Wide-based gait
Wide-based gait
A gait pattern where the feet are placed wider apart than usual, often a sign of balance problems or neurological issues.
Steppage gait
Steppage gait
An exaggerated lifting of the leg to avoid dragging the foot, indicating weakness in ankle dorsiflexors.
Foot drop
Foot drop
Inability to lift the front part of the foot, leading to dragging during walking and increased fall risk.
Trendelenburg test
Trendelenburg test
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Thomas test
Thomas test
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Ober test
Ober test
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Pelvic fracture mechanism
Pelvic fracture mechanism
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Hip reduction (ER)
Hip reduction (ER)
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Non-displaced fracture
Non-displaced fracture
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Intertrochanteric fracture
Intertrochanteric fracture
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Femoral shaft fracture
Femoral shaft fracture
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Hip dislocation
Hip dislocation
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Hip osteoarthritis
Hip osteoarthritis
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SCFE
SCFE
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Avascular necrosis
Avascular necrosis
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Hip labral tear
Hip labral tear
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Femoral acetabular impingement
Femoral acetabular impingement
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Osteomyelitis
Osteomyelitis
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Pulled groin injury
Pulled groin injury
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Trochanteric bursitis
Trochanteric bursitis
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Study Notes
Gait Analysis and Muscle Weakness
- A wide-based gait is often indicative of balance issues or neurological conditions affecting gait stability.
- Steppage gait results from weakness in ankle dorsiflexors, leading to an exaggerated lifting of the leg to avoid dragging the foot.
- Pushing on the thigh with the hand during stance phase is a compensatory mechanism to stabilize a weak or unstable knee.
- Weak ankle dorsiflexors are associated with foot drop, causing the foot to drag during walking.
- Foot drop results in an inability to lift the front part of the foot, increasing fall risk and gait disturbances.
- A significant drop in the pelvis on the unsupported side during the Trendelenburg test suggests weakness in the gluteus medius muscle.
- If the thigh remains flat against the table during the Thomas test, it indicates tight hip flexor muscles.
- Tight hip flexor muscles can lead to reduced hip extension and anterior pelvic tilt, potentially causing discomfort or limitations in mobility.
- Significant pelvic tilt during the Trendelenburg test typically points to gluteus medius weakness.
- During the Ober test, the unaffected side is typically in a neutral or relaxed position.
- If the thigh remains abducted or cannot adduct past the horizontal position during the Ober test, it indicates tightness in the iliotibial band or hip abductor muscles.
- The Trendelenburg test assesses hip abductor strength, particularly the gluteus medius muscle's functionality.
Fractures and Injuries
- The most common mechanism of injury for pelvic fractures is high-energy trauma, such as falls or accidents.
- Hip reduction in the emergency room is typically accomplished through manipulation under anesthesia.
- Lengthy bed rest post-hip fracture, especially if not surgically repaired, can increase the risk of complications like deep vein thrombosis or pulmonary embolism.
- A complete femoral neck fracture without displacement is classified as a non-displaced fracture.
- For intertrochanteric fractures of the femur, a surgical repair approach involves internal fixation with plates or nails.
- Femoral shaft fractures require surgical intervention using techniques such as intramedullary nailing for stabilization.
- Diagnostic imaging for assessing pelvic fractures commonly includes X-rays or CT scans.
- Common risk factors for hip fractures in elderly patients include osteoporosis and falls.
- Avascular necrosis is heightened in patients undergoing long-term use of corticosteroids or those with underlying vascular problems.
- Distal femur fractures are typically repaired using plates and screws or intramedullary rods.
- The most common type of hip dislocation is posterior dislocation, often requiring closed reduction.
- The Garden Type Two femoral neck fracture is characterized by partial displacement of the femoral head.
- Garden Type Four femoral neck fractures necessitate surgical intervention often via hip arthroplasty.
- A defining characteristic of pelvic fractures can include significant soft tissue damage and involvement of adjacent structures.
Symptoms and Treatments
- Conservative first-line treatment for a hip labral tear includes NSAIDs, rest, and physical therapy; if unsuccessful, hip arthroscopy may be indicated.
- Symptoms of hip osteoarthritis often include joint stiffness and pain during weight-bearing activities.
- MRI is the imaging modality of choice for diagnosing a labral tear of the hip.
- Patients with femoral acetabular impingement may experience groin pain exacerbated by prolonged sitting or activity.
- Definitive treatment for osteoarthritis of the hip may require total hip replacement surgery.
- Athletes with femoral acetabular impingement commonly report issues with range of motion and hip pain during sports activities.
- A labral tear may lead to similar symptoms, including clicking or catching sensations in the hip joint.
- In hip osteoarthritis, NSAIDs and intraarticular injections can provide pain relief until surgical options are appropriate.
- Intraarticular injections are typically performed under imaging guidance for accuracy.
- MRI is considered the gold standard for diagnosing avascular necrosis of the hip.
- Not all microorganisms commonly cause septic joint; certain atypical pathogens may be excluded.
Pediatric and Joint Conditions
- Conservative management for Slipped Capital Femoral Epiphysis (SCFE) may include observation and activity restriction.
- Surgical options for avascular necrosis of the hip typically involve core decompression rather than reconstructive surgery.
- A defining feature of a pulled groin injury is sudden onset pain during activities involving rapid or forceful movements.
- Symptoms indicating SCFE may include hip pain, limping, or inability to bear weight.
- SCFE is most prevalent in adolescents, particularly those who are overweight or experiencing growth spurts.
- The most common causative agent of osteomyelitis is Staphylococcus aureus, often requiring aggressive treatment.
- Avascular necrosis of the hip presents with gradual pain and potential loss of function in the affected joint.
- Trochanteric bursitis typically presents as lateral hip pain, often exacerbated with specific movements or pressure.
- A positive test in external snapping hip indicates issues related to the iliotibial band over the greater trochanter.
- Internal snapping hip syndrome due to iliopsoas tendons typically requires stretching exercises or physical therapy for management.
- Common treatments for trochanteric bursitis include rest, ice, and corticosteroid injections to reduce inflammation.
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Description
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.
