The clinician must be aware of disorders affecting the _____ and ______ organs that can also referred pain to the hip region, mimicking a musculoskeletal dysfunction
ABDOMINAL AND PELVIC The clinician must be aware of disorders affecting the abdominal and pelvic organs that can also referred pain to the hip region, mimicking a musculoskeletal dysfunction
what is a particular red flag in men and women for the hip joint? (think: metastases)
Previous history of cancer, such as prostate cancer in men or any reproductive cancer or breast cancer in women is a red flag since these cancers may be associated with metastases to the hip joint
List the red flags for hip pathology:--------
red flags for hip pathology:- hx of cancer - groin pain - hx of trauma - fever - unexplained weight loss - burning with urination - night pain - prolonged corticosteroid use
Which red flags increase the risk for avascular necrosis?
- HX of corticosteroid use - alcohol abuse (due to the metabolic effects, not from falling)
Which special tests should a clinician use for potential red flags from non-musculoskeletal causes related to the hip?--
- resisted straight-leg raise test - heel-strike test
_________, which is characterized by low bone mass and micro architectural deterioration is a major risk factor for fractures of the hip, vertebrae, and distal forearm
Osteoporosis, which is characterized by low bone mass and micro architectural deterioration is a major risk factor for fractures of the hip, vertebrae, and distal forearm
T/F: Hip fracture is associated with 20% mortality and 50% permanent loss in function. Presence of a hip fracture warrants referral to a physician
What test do you use to rule in or rule out the presence of a fracture of the hip?
patellar-pubic percussion test (SN 95, SP86)
what is the SN/SP for patellar-pubic percussion test
SN 95, SP 96
What test do you use to rule in or rule out the presence of a STRESS fracture of the hip region?
Once you rule out red flags, what should you do to differentiate the mini potential pain referral sources?
Lower quarter screening examination "once red flags are ruled out, and efficient way to begin to differentiate the mini potential pain referral sources is through the lower quarter screening examination. The traditional lower quarter screen consists of testing dermatomes, myotomes, deep tendon reflexes, and possible upper motor involvement.
What other regions/joints should the clinician differentially diagnose in terms of potential contribution?:--
-SIJ or PG -L/S
what are the SN tests that we use in triage of the hip to R/O the L/S?
For RADICULOPATHY or DISCOGENIC-RELATED PATHOLOGY:-repeated motions (centralization or peripheralization): 5-20 reps ^^SN 92-SLR test^^SN97-Slump ^^SN83FACET JOINT DYSFUNCTION: -seated extension-rotation ^^SN 100
what are the SN tests that we use in triage of the hip to R/O the SIJ?
Thigh thrust test (SN 88)
what is a sensitive test for the hip that clinicians should use to assist in ruling out hip impingement, or labral tear, or potential intra-articular involvement?
FADDIR (flexion-adduction-IR test)^^ one pooled analysis says SN 94, another says SN 99(it also mentions the flexion-internal rotation test, but I think we just do FADDIR)
what's the close-packed position of the hip?
hip Extension hip IR hip ABD
what's the resting position of the hip?
30* flexion 30* ABD slight ER
what's the capsular pattern of the hip?