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Questions and Answers

What are the possible causes of pain in the posterior thigh?

  • Rectus femoris pathology (correct)
  • Hamstring pathology (correct)
  • Ilioposoas pathology (correct)
  • Gluteus medius pathology (correct)
  • Piriformis pathology (correct)
  • ITB/TFL pathology (correct)
  • Sartorius pathology (correct)

    • True leg length discrepancy is measured as a difference between the ASIS and medial malleolus of 1-1.5 cm, side-side.

    True

    Where is the pain location associated with osteitis pubis?

  • Medial thigh/groin area, away from the pubic symphysis.
  • Right at the pubic symphysis. (correct)
  • Along the ITB/greater trochanter.
  • Deep in the hip/ischial tuberosity.

    • The pain associated with iliolumbar SI ligament sprain is typically located in the lower back.

    <p>True</p> Signup and view all the answers

    Which type of hip pathology is associated with the feeling of "catching, locking, and clicking"?

    <p>OA</p> Signup and view all the answers

    When performing the SLR test, if the pain is present in the anterior thigh, it is associated with femoral nerve AN.

    <p>True</p> Signup and view all the answers

    What is the pain location associated with external snapping hip syndrome?

    <p>Along ITB/greater trochanter</p> Signup and view all the answers

    Which of these is NOT a common finding when assessing the piriformis pathology patient?

    <p>Hypertrophy</p> Signup and view all the answers

    The goniometer measurement is below 8 degrees in Anteroversion.

    <p>False</p> Signup and view all the answers

    What are possible causes of pain in the anterior thigh?

    <p>Sartorius pathology</p> Signup and view all the answers

    Where is the pain location associated with adductor pathology?

    <p>Medial thigh/groin area, away from the pubic symphysis</p> Signup and view all the answers

    True sciatica may have normal strength and length.

    <p>True</p> Signup and view all the answers

    What is the pain location associated with iliopsoas pathology?

    <p>Could go into the lumbar spine</p> Signup and view all the answers

    Adductor pathology can be either acute or chronic.

    <p>True</p> Signup and view all the answers

    The pain associated with a labral tear is often localized.

    <p>True</p> Signup and view all the answers

    Internal snapping hip syndrome is painful at degrees of when returning from.

    <p>True</p> Signup and view all the answers

    Osteitis pubis is exclusively chronic/long-standing.

    <p>True</p> Signup and view all the answers

    The pain in the anterior thigh associated with femoral nerve AN is felt below 80 degrees of straight leg hip flexion.

    <p>False</p> Signup and view all the answers

    What is the pain location associated with true sciatica?

    <p>Below knee, radiating starting from low back down the posterior thigh and leg</p> Signup and view all the answers

    The joint play reduces with FAI.

    <p>True</p> Signup and view all the answers

    What are the measurements of a true leg length discrepancy?

    <p>1-1.5 cm side-side difference between the ASIS and medial malleolus</p> Signup and view all the answers

    What is the observation for an iliac crest contusion?

    <p>Disproportionate swelling at the iliac crest</p> Signup and view all the answers

    What is the pain quality for an iliac crest contusion?

    <p>Sharp, stabbing</p> Signup and view all the answers

    What is the pain location for an avulsion fracture of the iliac crest?

    <p>Visible bony prominence within a few millimeters from the iliac crest</p> Signup and view all the answers

    What is the age group associated with apophysitis?

    <p>Adolescents</p> Signup and view all the answers

    What is the pain duration for osteitis pubis?

    <p>Exclusively chronic/long-standing</p> Signup and view all the answers

    What is the pain location for adductor pathology?

    <p>More in the medial thigh/groin area, away from the pubic symphysis</p> Signup and view all the answers

    What is the pain location for FAI?

    <p>Localized</p> Signup and view all the answers

    What is the pain location for labral tear?

    <p>General</p> Signup and view all the answers

    What is the pain location for intra-articular snapping hip syndrome?

    <p>Localized</p> Signup and view all the answers

    What is the age group associated with OA?

    <p>Older</p> Signup and view all the answers

    What is the special test associated with OA?

    <p>Catching, locking, clicking</p> Signup and view all the answers

    What is the special test associated with labral tear?

    <p>FADDIR</p> Signup and view all the answers

    What is the ROM affected for FAI?

    <p>FLEX + IR are less likely to be affected than OA</p> Signup and view all the answers

    What is the ROM affected for labral tear?

    <p>All ROM</p> Signup and view all the answers

    What is the ROM affected for intra-articular snapping hip syndrome?

    <p>None</p> Signup and view all the answers

    What are two population groups associated with FAI?

    <p>Kicking athletes and dancers</p> Signup and view all the answers

    What is the pain location associated with ischial bursitis?

    <p>Deep in the hip, ischial tuberosity</p> Signup and view all the answers

    What is the pain location associated with trochanteric bursitis?

    <p>Lateral thigh</p> Signup and view all the answers

    What is the pain location associated with proximal hamstring pathology?

    <p>Localized, deep in the thigh</p> Signup and view all the answers

    What is the pain character associated with a femoral shaft stress fracture?

    <p>Sharp pain + shaft pain at femoral fulcrum</p> Signup and view all the answers

    What is the pain location associated with intra-articular snapping hip syndrome?

    <p>Any intra-articular pathology test, particularly</p> Signup and view all the answers

    What is the pain location associated with piriformis pathology?

    <p>Exclusively at hip</p> Signup and view all the answers

    What is the pain location associated with sciatic nerve AN?

    <p>Posterior thigh</p> Signup and view all the answers

    What is the pain location associated with tibial nerve AN?

    <p>Posterior lower leg + sole</p> Signup and view all the answers

    What is the pain location associated with common fibular nerve AN?

    <p>Lateral knee, lower leg, foot</p> Signup and view all the answers

    What is the pain location associated with large disc lesion?

    <p>Symptoms going from spine all the way down</p> Signup and view all the answers

    What is the special test associated with anterior thigh AN?

    <p>Yeoman's, anterior thigh AN</p> Signup and view all the answers

    Match the following terms with their corresponding descriptions in relation to True vs. functional leg length discrepancy:

    <p>True leg length discrepancy = 1-1.5 cm side-side difference between the ASIS and medial malleolus Functional leg length discrepancy = 1-1.5 cm side-side difference between the ASIS and medial malleolus Observation = N/A Special test = N/A Measurements = N/A</p> Signup and view all the answers

    Match the following conditions with their corresponding clinical presentations:

    <p>Iliac crest contusion = Swelling disproportionate at Iliac crest fracture = Some swelling Avulsion fracture = Visible bony prominence within a few millimeters from the iliac crest Apophysitis = Some swelling</p> Signup and view all the answers

    Which of these options are accurate regarding the pain associated with an iliac crest contusion?

    <p>Sharp, stabbing pain</p> Signup and view all the answers

    Which of these sports are commonly associated with iliac crest contusions?

    <p>Volleyball</p> Signup and view all the answers

    What is the typical pain quality experienced with an iliac crest fracture?

    <p>Dull aching pain</p> Signup and view all the answers

    Which of these findings are associated with an avulsion fracture?

    <p>Visible bony prominence within a few millimeters from the iliac crest</p> Signup and view all the answers

    What is a common characteristic of pain associated with Apophysitis?

    <p>Dull aching pain</p> Signup and view all the answers

    Which age group is most commonly affected by Apophysitis?

    <p>Adolescents</p> Signup and view all the answers

    What is the typical duration of pain associated with Osteitis pubis?

    <p>Chronic (long-term)</p> Signup and view all the answers

    Where is the pain typically located in Osteitis pubis?

    <p>Right at the pubic symphysis</p> Signup and view all the answers

    Which of these conditions is characterized by acute or chronic pain located more in the medial thigh/groin area, away from the pubic symphysis?

    <p>Adductor pathology</p> Signup and view all the answers

    Osteitis pubis is more commonly seen in athletes involved in kicking sports, such as football and soccer.

    <p>True</p> Signup and view all the answers

    Match the following conditions with their corresponding pain locations:

    <p>FAI = Localized OA = General Labral tear = General Intra-articular snapping hip syndrome = Localized</p> Signup and view all the answers

    Which of these conditions is typically associated with catching, locking, and clicking sensations in the hip?

    <p>OA</p> Signup and view all the answers

    The FADDIR test, which assesses for pain when the hip is flexed and internally rotated, is more likely to be positive in patients with OA than those with FAI.

    <p>False</p> Signup and view all the answers

    Labral tears are more likely to affect all ranges of motion (ROM) in the hip compared to FAI.

    <p>True</p> Signup and view all the answers

    Which of these findings is characteristic of piriformis pathology?

    <p>Pain localized exclusively at the hip</p> Signup and view all the answers

    The Ober's test and Kendall's test are useful for assessing for tightness of the piriformis muscle.

    <p>True</p> Signup and view all the answers

    Which of these conditions is characterized by pain radiating down the posterior thigh and leg, often starting from the low back?

    <p>True sciatica</p> Signup and view all the answers

    Which of these conditions is more likely to cause hypertrophied or shortened muscles?

    <p>Pseudo sciatica</p> Signup and view all the answers

    Select the condition that is characterized by pain localized along the ITB and greater trochanter?

    <p>External snapping hip syndrome</p> Signup and view all the answers

    Internal snapping hip syndrome typically occurs when the hip returns from 90 degrees of flexion.

    <p>True</p> Signup and view all the answers

    Which of these findings is most suggestive of an intra-articular snapping hip syndrome?

    <p>Any intra-articular pathology test</p> Signup and view all the answers

    Active straight leg raise (SLR) is typically painful in patients with femoral neck stress fractures.

    <p>True</p> Signup and view all the answers

    Where is the pain usually localized in a patient with a femoral shaft stress fracture?

    <p>Generalized pain along the length of the femur</p> Signup and view all the answers

    Which of these findings is more likely to aggravate a femoral neck stress fracture?

    <p>Weight-bearing activities</p> Signup and view all the answers

    Which of these signs is most likely to be present in a patient with a femoral shaft stress fracture?

    <p>Catching or locking sensation in the hip</p> Signup and view all the answers

    Which special test is used to assess for a one-sided iliosacral somatic dysfunction?

    <p>Standing flexion test</p> Signup and view all the answers

    The sacrospinous ligament limits all hip movements, including counter-nutation.

    <p>False</p> Signup and view all the answers

    Which of the following conditions is more likely to present with pain in the lower back?

    <p>Iliolumbar SI</p> Signup and view all the answers

    Choose the condition most likely to have pain located in the central area of the sacrum, possibly causing pressure on the middle of the sacrum.

    <p>Interosseous SI</p> Signup and view all the answers

    Which of these conditions is characterized by pain located posteriorly, involving the entire sacrum and ischial tuberosity, often exacerbated with all movements?

    <p>Sacrotuberous SI</p> Signup and view all the answers

    Which of these special tests is mainly used to assess for pain in the upper pole of the SI joint?

    <p>Approximation test</p> Signup and view all the answers

    The Hibbs test, a special test to check for SI joint dysfunction, commonly causes pain in the lower pole of the SI joint.

    <p>True</p> Signup and view all the answers

    Which of these conditions is more likely to result from counter-nutation?

    <p>Anterior SI</p> Signup and view all the answers

    Which of these conditions is commonly affected by a combination of counter-nutation, anterior translation, and posterior translation?

    <p>Anterior SI</p> Signup and view all the answers

    The goniometer measurement for anteroversion should be greater than 15 degrees.

    <p>True</p> Signup and view all the answers

    In retroversion, the goniometer measurement is typically below 8 degrees.

    <p>True</p> Signup and view all the answers

    Select the condition that is often characterized by pain in the hip during hiking or when the foot is at a top position.

    <p>Rectus femoris</p> Signup and view all the answers

    Which special test is commonly used to assess for tight piriformis muscles?

    <p>FABER</p> Signup and view all the answers

    A positive Trendelenburg sign is indicative of a tight sartorius muscle.

    <p>False</p> Signup and view all the answers

    Which of these conditions is commonly associated with pain in the lower leg, sometimes extending down the length of the sartorius muscle?

    <p>Sartorius</p> Signup and view all the answers

    Which of these conditions is most likely to present with a decreased range of motion (ROM) in abduction and external rotation of the hip?

    <p>Piriformis pathology</p> Signup and view all the answers

    The tripod sign, characterized by an excessive inward lumbar curve, is commonly seen in patients with piriformis syndrome.

    <p>False</p> Signup and view all the answers

    Which of these conditions typically presents with pain radiating down the posterior thigh and leg, starting from the low back, and potentially affecting the lower leg and foot?

    <p>True sciatica</p> Signup and view all the answers

    Pseudo sciatica is commonly associated with hypertrophied or shortened muscles.

    <p>True</p> Signup and view all the answers

    Which nerve is most likely to be affected in patients with sciatic nerve an?

    <p>Common fibular nerve</p> Signup and view all the answers

    The symptom location in a patient with sural nerve an typically involves the lateral lower leg.

    <p>True</p> Signup and view all the answers

    The symptom location in a patient with femoral nerve an is usually in the anterior thigh.

    <p>True</p> Signup and view all the answers

    The SLR #5 test assesses the integrity of the anterior thigh nerve root.

    <p>True</p> Signup and view all the answers

    Select the condition that is typically associated with symptoms radiating from the spine all the way down?

    <p>Large disc lesion</p> Signup and view all the answers

    Study Notes

    True vs. Functional Leg Length Discrepancy

    • Leg length discrepancy is measured as 1-1.5 cm difference between the ASIS (Anterior Superior Iliac Spine) and medial malleolus.
    • True leg length discrepancy shows a consistent difference.
    • Functional leg length discrepancy shows a similar but inconsistent difference.

    Iliac Crest Contusion vs. Fracture vs. Avulsion vs. Apophysitis

    • Iliac crest contusion: Swelling, disproportionate at the site. Pain is sharp and stabbing. Common in sports like volleyball and diving. Aggravated by activities like weight bearing.
    • Iliac crest fracture: Some swelling, visible bony prominence within a few millimeters of the iliac crest. Pain is sharp and stabbing and aggravated by weight bearing.
    • Avulsion fracture: Visible bony prominence within a few millimeters of the iliac crest. Pain is sharp and stabbing, aggravated by resisted movements.
    • Apophysitis: Characterized by some swelling with sharp, stabbing pain. Aggravated by certain movements, specifically in the case of apophysitis, it would depend on where the apophysis is being affected.

    Osteitis Pubis vs. Adductor Pathology

    • Osteitis pubis: Exclusively chronic/long-standing pain, localized right at the pubic symphysis.
    • Adductor pathology: The pain is acute or chronic and localized more in the medial thigh/groin area, away from the pubic symphysis.

    FAI vs. OA vs. Labral Tear vs. Intra-articular Snapping Hip Syndrome

    • FAI (Femoroacetabular impingement): Localized pain, scour test shows bone-to-bone end feel. Pain is localized, onset with flexion and internal rotation (IR) is less likely affected than osteoarthritis.
    • OA (Osteoarthritis): General pain, catching, locking, and clicking are common. Pain is generalized, onset with flexion and internal rotation (IR) is more likely to be affected.
    • Labral tear: General pain, FADDIR is most affected in all ROM.
    • Intra-articular snapping hip syndrome: General pain, FADDIR affected in all ROM.

    Ischial vs. Trochanteric Bursitis vs. Proximal Hamstring Pathology

    • Ischial bursitis: Pain deep in the ischial tuberosity, aggravated by weight bearing. Pain is localized in the deep ischial area.
    • Trochanteric bursitis: Pain along the greater trochanter, aggravated by internal rotation and abduction of the hip. Pain can be sharp/stabbing or dull/aching.
    • Proximal hamstring pathology: Pain along the hamstring, aggravated with resisted hip movements. Pain might be felt more at insertion points or along the muscle belly, varying in location and intensity, depending on the specific affected area within the hamstrings.

    Piriformis Pathology vs. External vs. Internal vs. Intra-articular Snapping Hip Syndrome

    • External snapping hip syndrome: Localized pain on the IT band/greater trochanter.
    • Internal snapping hip syndrome: Pain deep in the hip and aggravated by hip movements. The specific location and pain associated with internal snapping may vary based on triggering structures in each patient.
    • Intra-articular snapping hip syndrome: Any intra-articular test present and the pain often felt deep within the joint

    Femoral Neck vs. Femoral Shaft Stress Fracture

    • Femoral neck: Active SLR - pain deep in the hip; ischial or trochanteric pain, pain felt along the length of the femur, localized, deep in the thigh
    • Femoral shaft: Pain through the shaft pain at femoral shaft and Fulcrum. Ischial deep in the hip, pain

    One-sided vs. Two-sided Iliosacral Somatic Dysfunction

    • One-sided: Standing flexion - affected side moves more.
    • Two-sided: Gillet's - affected side moves less.

    Anterior vs. Posterior SI vs. Sacrotuberous vs. Sacrospinous vs. Interosseous vs. Iliolumbar

    • Pain location: varies from anterior to posterior, between the entire sacrum to ischial tuberosity, and lower back or central, more posterior than with sacrotuberous, and almost all most commonly in rotatory motion.
    • Special tests: includes gapping, squish and Hibbs (all pain @ SI).

    Upper vs. Lower Pole SI Dysfunction

    • Upper pole SI dysfunction: Pain at the superior portion of the SI joint, aggravated by approximation.
    • Lower pole SI dysfunction: Pain at the inferior portion of the SI joint, aggravated by squish and Hibbs (all pain @ SI) and can range from both posterior and inferior to sacral sulci

    Anteroversion vs. Retroversion

    • Anteroversion: Measurement of greater than 15 degrees.
    • Retroversion: Measurement below 8 degrees.

    Hamstring vs. Iliopsoas vs. Rectus Femoris vs. ITB/TFL vs. Piriformis vs. Gluteus Medius vs. Sartorius

    • Hamstring: Pain in posterior thigh.
    • Iliopsoas: Could go into the lumbar, pain in the anterior thigh.
    • Rectus femoris: Anterior thigh pain.
    • ITB/TFL: Lateral thigh pain.
    • Piriformis: Posterior buttock pain and may radiate at times
    • Gluteus medius: Posterior buttocks pain, can be at times on the side
    • Sartorius: Pain travels from lateral thigh to medial knee. There can be variation between patients.

    Piriformis Pathology vs. True vs. Pseudo Sciatica

    • Piriformis pathology: Exclusively at the hip: Localized pain at the hip. Pain often is described as only at the hip.
    • True sciatica: Below knee, radiating from the low back down the posterior thigh and leg. Pain is typically associated with nerve compression; symptoms typically begin in the lower back and radiate down the leg.
    • Pseudo sciatica: Above the knee and may radiate down, symptoms often begin in hip and often described as radiating to the buttock. Pain less diffuse than true sciatica.

    Sciatic vs. Tibial vs. Sural vs. Common Fibular vs. Large Disc Lesion vs. Femoral Nerve Pathology

    • Sciatic nerve AN: Posterior thigh pain and can be sharp or burning.
    • Tibial nerve AN: Posterior lower leg (plus sole).
    • Sural nerve AN: Lateral lower leg.
    • Common fibular nerve AN: Lateral knee, lower leg, foot. Sharp and numb sensation are common.
    • Large disc lesion: Symptoms begin in the spine and shoot all the way down to the lower leg/foot.
    • Femoral nerve AN: Anterior thigh and often described as sharp, radiating pain.

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