1. Hip & Pelvis
Injuries & Illnesses

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Apophysitis
Sudden pain ischial hamstring origin rectus femoris attachement
Felt a snap during sudden deceleration
Point tender over muscle attachment, has edema, & ROM increase pain
X-ray, RICE, crutch walking 1-2 months, NSAID’s, gradual stretching when pain subsides
9/15/2018
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Athletic Pubalgia
Pain in the abdominopelvic region of the body on the anteior side
Activities of daily living (ADL’s) have become uncomfortable
Palpable bulge in the groin region near the pubis
Like an inguinal hernia; treated by surgery to fix bulge
9/15/2018
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9/15/2018
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9/15/2018
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6. Contusion (Hip Pointer)
Sustained a direct blow to iliac crest
Hurts to flex and extend hip
Spasm in inguinal region, ecchymosis present and edema over ASIS
Can not rotate trunk without pain
RICE, NSAIDS, refer to MD for x-ray
9/15/2018
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9/15/2018
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8. Femoral Shaft Fracture
Sustained direct traumatic blow to greater trochanter
Leg is deformed and can not move
Activate EMS
X-ray, treat with intramedullary rod and weight bear immediately post-op
With a severe fracture, use tibial traction pin with rod
9/15/2018
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9/15/2018
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Groin Strain
Felt a slight pull when running and jumping and had externally rotated hip
Point tender over adductor muscle
Ecchymosis and edema
RICE, NSAIDS, CWP, gradual stretching
9/15/2018
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9/15/2018
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Hip Anterversion
Skeletal disorder where there is excessive medial rotation of the femur
Walks pigeon toed
History of patellar chondromalacia
Condition normally corrects itself by age of 7-8
9/15/2018
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Hip Dislocation
Involved in catastrophic trauma during a football game
Violently twisted hips while knee stayed in place
Sudden and severe pain, found lying supine with hip internally rotated and unable to move
Activate EMS
Monitor vitals especially LE pulses
MD will reduce dislocation and splint
9/15/2018
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9/15/2018
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Hip Retroversion
Skeletal disorder where there is excessive lateral rotation of the femur
Tightness in back and hips
“toe-out” gait
Condition might fix itself; children may wear braces to fix disorder
9/15/2018
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16. IT Band Friction Syndrome
Discomfort on the lateral aspect of the thigh
Pain worsens with running, stair climbing and getting out of a car
+ Ober’s Test
Treat by RICE, stretching, change shoes and running patterns
9/15/2018
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9/15/2018
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9/15/2018
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19. Legg-Calve Perthes Disease
A young male child (3-8) questions why he’s been limping and having pain in the knee and groin; states leg goes “tingly”
Point tender on anterior thigh region, groin, and knee
Has decreased hip abduction, extension, and external rotation
Treatment involves immobilization and possible surgery; if detected too late, hip replacement
9/15/2018
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Osteitis Pubis
Presents with aching pain that is localized in anterior groin region
Relieved with rest but worsens with weight bearing
Point tender over pubic symphysis
Pain with adduction and flexion
X-ray reveals stress fracture
Treat symptomatically
9/15/2018
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Piriformis Syndrome
Aching mid-buttock region with numbness down the leg, low back pain, and decreased ADL’s
Weakness with hip abduction & ER
+ FABER Test
RICE, NSAIDS, stretching
9/15/2018
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9/15/2018
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Pubis Stress Fracture
Normally found in cyclist or distance runners due to the reaction force of the pelvis during impact
More common in women than men
c/o general groin pain that increases with activity
Can not stand on one leg b/c of pain
Treatment is rest and swimming for aerobic exercise – AVOID breaststroke
9/15/2018
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9/15/2018
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26. Slipped Capital Femoral Epiphysis
Tall thin boy between y.o.
c/o pain in both hips
Limited in ABD, flexion, & IR
Has antalgic gait
X-ray shows femoral head slipping inferiorly and posteriorly
Minor cases – rest, NWB
Major cases – surgery to restore normal hip mechanics
9/15/2018
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28. Trochanteric Bursitis
c/o discomfort on lateral hip
Pain can radiate down leg
Has a limp
States they have been running in the same direction every day
More common in females b/c of increased Q-Angle
Point tender over greater trochanter
RICE, NSAIDs, prohibit hill running
9/15/2018
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9/15/2018
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