Hip Pathologies

1
Hip Pathologies
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Structural and Functional Abnormalities

• Normal Angulation of Femur
• Head to shaft angle 120-125 degrees
• Forward angulation 14-15 degrees
• Coxa Vara
• Angulation lt 120
• Coxa Valga
• Angulation gt135

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Structural and Functional Abnormalities

• Hip Anteversion
• Excessive anterior angulation
• Toe in gait
• Enlarges Q-angle
• Hip Retroversion
• Decreases anterior angle
• Toe-out gait

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Hip Sprains, Dislocation, Subluxations

• Sprain
• Mechanism
• Violent twist with a impact force
• Forceful contact with another object
• Planted foot with violent rotation
• S/S
• All signs of acute sprain
• Inability to circumduct hip

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Hip Sprains, Dislocation, Subluxations

• Sprain
• Dislocation/Subluxation
• Rare in sports
• Mechanism
• Impact along long axis of femur driving femoral
  head posteriorly
• S/S
• Posterior deformity
• Hip flexed, ADD and IR
• Palpable defect posteriorly
• Severe pain
• Possible fracture

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Fractures

• Stress Fractures
• Mechanism
• S/S
• Avulsion Fractures/Apophysisits
• Mechanism
• S/S

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Fractures

• Stress Fractures
• Mechanism
• S/S
• Avulsion Fractures/Apophysisits
• Mechanism
• S/S
• Hip and Pelvic Fractures
• Hip femoral neck
• Pelvis acetabulum
• S/S

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Adductor Muscle Strain

• Mechanism
• S/S
• Grade I
• Grade II
• Grade III

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Trochanteric Bursitis

• Mechanism
• S/S
• Pain
• Point tender
• Swelling
• Loss of funtion

10
Slipped Capital Femoral Epiphysis

• Mechanism
• Boys 10-17
• Tall and thin
• Femoral head slips posteriorly and inferiorly
• S/S
• Pain in groin area
• Acutely or chronic
• Advanced stage pain w/ AROM/PROM
• Limitations

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Legg-Calve Perths Disease (Coxa Plana)

• Mechanism
• Avascular Necrosis of femoral head
• 4-10 girls most often
• Idiopathic mechanism
• S/S
• Pain in groin
• Referred to knee and abdomen

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Snapping Hip Phenomena

• Mechanism
• Repetitive lateral rotation and hip flexion
• Muscle imbalance
• Most often chronic bursitis
• Can be due to joint capsule, ligaments and
  adductor muscle
• S/S
• Chief complaint
• Pain
• inflammation

13
Iliac crest contusion (Hip Pointer)

• Mechanism
• S/S

14
Osteitis Pubis

• Mechanism
• Irritation and inflammation of the pubic
  symphysis
• S/S

15
Piriformis Syndrome

• Mechanism
• 12 nerve splits and goes through piriformis
• S/S