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The Hip

The Hip. Differential Diagnosis & Treatment Mazyad Alotaibi. Capsular Lesions. Most loss of medial rotation Less of flexion and abduction Least of extension. Osteoarthritis. OA most common joint disorder Risk factors – family history, obesity, injury, occupation, elite athletes

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The Hip

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  1. The Hip Differential Diagnosis & Treatment Mazyad Alotaibi

  2. Capsular Lesions • Most loss of medial rotation • Less of flexion and abduction • Least of extension

  3. Osteoarthritis • OA most common joint disorder • Risk factors – family history, obesity, injury, occupation, elite athletes • A- joint space narrowing • B- marginal osteophytes • C- marginal sclerosis • D- cystic changes in the head of the acetabulum

  4. Osteoarthritis • Treatment • Stage 1) heat + slow stretches into MR, ext, abd and flex • +hep • Stage 2) steriod injec + rest • Stage 3) surgery

  5. Non capsular

  6. Loose Body • Pain on lat rot with abd or flex with springy end feel • Twinges of pain • Refer to surgeon for opinion re: EUA

  7. Contractile lesions

  8. Hamstrings, adductor longus and rectus femoris • Resisted test painful • Sudden onset – overstreching • Hams and rec fem due to combined movts over 2 joints • Hamstrings • Rectus Femoris • Adductor Longus • Treatment – deep friction and rest or steriod injec and rest

  9. Bursa

  10. Trochanteric Bursitis • Resisted hip abd in side lying • Direct trauma • Treatment – injec or electrotherapy + rest

  11. Psoas Bursitis • Test with passive flex 90 degrees and add • Also resisted hip flex • Overuse • Occasional trauma • Treatement –injec or electrotherapy + rest

  12. Gluteal Bursitis • Pain on passive flexion, add and abduction • Pain on resisted abduction and extension • Sup and post to trochanter • Overuse • Treatment – injec or electrotherapy + rest

  13. Sign of the Buttock • Indicates possible neoplasm, abcess, fracture, osteomyelitis, sepsis • Pain on: trunk flexion passive hip flex with empty end feel SLR resisted hip movements

  14. Groin Pain

  15. Groin Pain • Psoas bursa • Sportsman’s Hernia • OA Hip, perthes disease, loose body • L3 • Ref from SIJ • Osteitis pubis • Slipped epiphysis • Gynae/ genito urinary

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