Applied Anatomy
What type of joint is the hip?
Ball and Socket
This type of hip pain involves pathology of structures inside the hip joint such as the labrum, articular surfaces, and synovium.
Intra-articular hip pain
What does FABER stand for?
Flexion, ABduction, External Rotation
Pain over the greater trochanter, worsened by lying on the side and pain with weight bearing tasks are characteristic of this condition.
Greater Trochanteric Pain Syndrome
Issues with gluteus medius and minimus tendons.
What is the Beighton Scale Used for?
General Laxity
What is the closed pack position of the hip and is it the point with the most boney congruency?
Full EXT, IR, And
No, it't the point of the most muscular support
Entrapment of the sciatic nerve in the buttock region, often by the piriformis or gemelli muscles, is known as this syndrome.
Deep Gluteal Syndrome
Patients with intra-articular hip pain often have a positive result on these two special tests.
FADIR and FABER
This describes Pain related to narrowing of the space between the ischial tuberosity and the femur in which Impingement occurs with extension and/or adduction of the hip
Ischiofemoral Impingement
What are the 3 special tests for diagnosing lateral epicondylitis?
Cozens, Medleys, Mills
What is the superior border of the deep gluteal space?
Greater Sciatic Notch
This childhood condition is characterized by avascular necrosis of the femoral head and typically affects boys ages 3–12.
Legg-Calvé-Perthes Disease
This adolescent hip disorder involves the femoral head slipping at the growth plate and requires imaging to dx.
Slipped Capital Femoral Epiphysis (SCFE)
This condition involves hip instability or dislocation in infants and is associated with breech birth and family history.
Developmental Hip Dysplasia
This is the PRIMARY difference between back pain with mobility deficits versus movement coordination impairments.
Mobility deficits: hypo mobility, pain at end range
Movement Coordination Impairments: Hypermobility, challenge in midrange and muscle weakness.
What is the alpha angle measuring?
line from the center of the femoral head through the center of the neck
Normal: <60°
This condition is diagnosed with the following exam findings: IR > 30 degrees when hip is at 90 degrees of flexion, + FADIR and/or FABER, + micro instability tests, hx of clicking and popping, lateral center edge angle <25 degrees
Hip Instability
This is the Cluster for hip dysplasia
Positive FADIR/FABER
more than 30 deg IR ROM at 90 deg flex
Reports of instabilityH/o of clicking/popping
In this condition, abnormal bone morphology causes the femoral head to abut the acetabulum, producing pain with deep flexion.
Femoral- Acetabular Impingement (FAI)
This is the cluster for neck pain with radiating pain
+: General ULTT, Spurling's A, Distraction, <60 rotation ipsilateral
What is the 9 o-clock position on the clock drawing of the greater trochanter?
Conjoint tendon
This is the Cluster for Hip OA
Age >50
Hip Pain
Morning stiffness for <1 hr>/= 24 degrees less of hip IR or >/= 15 degrees difference side to side with FLEX AND IR of the affected hip (Seated)
Increased pain with passive IR of hip
Adductor-Related Groin Pain
Iliopsoas-Related Groin Pain
Inguinal-Related Groin Pain
Pubic-Related Groin Pain
A 15-year-old male presents with gradual onset groin and thigh pain that worsens with weight bearing. Examination reveals an antalgic gait, limited hip internal rotation, and the leg appears externally rotated when seated. Imaging confirms posterior displacement of the femoral head relative to the neck.
Later in life, this same patient develops anterior hip pain with sitting and squatting, limited IR (<20° at 90° hip flexion), and a positive FADIR test due to altered hip morphology.
What two pathologies likely occurred sequentially in this patient, and how did the first contribute to the second?
Slipped Capital Femoral Epiphysis (SCFE) followed by Cam-type Femoroacetabular Impingement (FAI)
List the following actions associated with the myotome C1-T1 and L1-S2 (ALL)
C1/C2 - Neck flexion, C3 - Neck side bend, C4 - Scapular elevation "shrug'' C5 - Shoulder abduction, C6 - Elbow flexion, wrist extension, C7 Elbow extension, wrist flexion, C8 - Thumb CMC ext, finger flexion, T1 - Finger abduction/adduction, L1/L2 - Hip Flexion, L3/L4 - Knee Ext, L5 - Big Toe Ext, S1/2 - Heel Raises (single leg x 10 ea)