HIP EXAM STUDY GUIDE
what is the importance of the pubic symphysis/arch?
adductors
what should you screen in addition to a hip exam?
low back and pelvis (bc they can mimic hip issues)
SIJ / lumbopelvic
where does the sartorius originate
ASIS
Where does the rectus femoris originate?
AIIS
which sacral ligament can be a pain generator that mimics hip pain
sacrotuberous ligament
purpose of fovea
for blood supply
where is the cartilage thickest at the hip and why
thickest in the superior-anterior region because there is a need for more cushion there
d/t most BW bared through the superior-anterior region
describe the carilage
limited blood supply and aneural
purpose of the acetabulum
acts as suction cup to the femoral head, it provides more stability because it is deep, the
labrum covers more of the femoral head compared to the labrum covering the glenoid in
the shoulder
this ligament is one of the strongest in the body
illiofemoral ligament (Y ligament)
what does the iliofemoral ligament restrict?
extension and ER
the inferior band restricts ABD
the superior band restricts ADD
what does the pubofemoral ligament restrict
,ABD, along with some extension
what does the ischiofemoral ligament restrict
IR, some extension
angle of inclination
The angle created by the femoral neck and proximal femur in the frontal plane, normal ~
120-125º
describe coxa valga
larger angle of inclination, >135º, more prone to dislocation and instability
describe coxa vara
smaller angle of inclination, <120º, manifests as a leg length discrepancy
describe torsion/version angle
The angle formed between the femoral neck and a line distally bisecting the femoral
condyles in the transverse plane (transcondylar axis).
Normal values are highly variable in adults and can range from 8-20
describe anteversion
the greater trochanter is more posterior,
Excessive anteversion is often associated with an "in-toeing" of the lower extremity
because this position provides a more congruent articulation with the acetabulum and
decreases tensile loading of anterior joint structures
hallmark finding with anteversion
excessive hip internal rotation ROM and decreased external rotation ROM
describe retroversion
the greater trochanter is more anterior,
often associated with toe-out of the lower extremity to similarly provide a more
congruent articulation with the acetabulum
which ROM is excessive and which is limited in retroversion
external rotation ROM is excessive while internal rotation is limited
which hip condition is most common in children
, slipped capital femoral epiphysis (SCFE), and it makes children more prone ti hip issues
during adulthood if SCFE present
what happens in SCFE
slippage of the proximal femoral epiphysis on the metaphysis through the epiphyseal
plate
(the growth plate is damaged and the femoral head moves/"slips" with respect to the
rest of the femur)
if bony elements are stable - no surgery
surgery if risk of future bone health/stability
• 8-15 y/o most common range
• males > females
• increased risk with obesity
A cam deformity is an anatomical variant characterized by:
The presence of excessive bone in the femoral head-neck region (alpha angle > 60°)
A pincer femoroacetabular impingement (FAI) is an anatomical variant characterized by:
Excessive coverage of the femoral head by the acetabular rim
which torsion angle can lead to dysplasia
anteversion
what is the importance of the pubic symphysis/arch?
adductors
what should you screen in addition to a hip exam?
low back and pelvis (bc they can mimic hip issues)
SIJ / lumbopelvic
where does the sartorius originate
ASIS
Where does the rectus femoris originate?
AIIS
which sacral ligament can be a pain generator that mimics hip pain
sacrotuberous ligament
purpose of fovea
for blood supply
where is the cartilage thickest at the hip and why
thickest in the superior-anterior region because there is a need for more cushion there
d/t most BW bared through the superior-anterior region
describe the carilage
limited blood supply and aneural
purpose of the acetabulum
acts as suction cup to the femoral head, it provides more stability because it is deep, the
labrum covers more of the femoral head compared to the labrum covering the glenoid in
the shoulder
this ligament is one of the strongest in the body
illiofemoral ligament (Y ligament)
what does the iliofemoral ligament restrict?
extension and ER
the inferior band restricts ABD
the superior band restricts ADD
what does the pubofemoral ligament restrict
,ABD, along with some extension
what does the ischiofemoral ligament restrict
IR, some extension
angle of inclination
The angle created by the femoral neck and proximal femur in the frontal plane, normal ~
120-125º
describe coxa valga
larger angle of inclination, >135º, more prone to dislocation and instability
describe coxa vara
smaller angle of inclination, <120º, manifests as a leg length discrepancy
describe torsion/version angle
The angle formed between the femoral neck and a line distally bisecting the femoral
condyles in the transverse plane (transcondylar axis).
Normal values are highly variable in adults and can range from 8-20
describe anteversion
the greater trochanter is more posterior,
Excessive anteversion is often associated with an "in-toeing" of the lower extremity
because this position provides a more congruent articulation with the acetabulum and
decreases tensile loading of anterior joint structures
hallmark finding with anteversion
excessive hip internal rotation ROM and decreased external rotation ROM
describe retroversion
the greater trochanter is more anterior,
often associated with toe-out of the lower extremity to similarly provide a more
congruent articulation with the acetabulum
which ROM is excessive and which is limited in retroversion
external rotation ROM is excessive while internal rotation is limited
which hip condition is most common in children
, slipped capital femoral epiphysis (SCFE), and it makes children more prone ti hip issues
during adulthood if SCFE present
what happens in SCFE
slippage of the proximal femoral epiphysis on the metaphysis through the epiphyseal
plate
(the growth plate is damaged and the femoral head moves/"slips" with respect to the
rest of the femur)
if bony elements are stable - no surgery
surgery if risk of future bone health/stability
• 8-15 y/o most common range
• males > females
• increased risk with obesity
A cam deformity is an anatomical variant characterized by:
The presence of excessive bone in the femoral head-neck region (alpha angle > 60°)
A pincer femoroacetabular impingement (FAI) is an anatomical variant characterized by:
Excessive coverage of the femoral head by the acetabular rim
which torsion angle can lead to dysplasia
anteversion
