Hip Differentials

What are the most common symptoms of hip OA?

Gradual deep hip pain and stiffness after inactivity.

Which hip motions are commonly limited in OA?

Internal rotation, abduction, and flexion.

What special tests may be positive in hip OA?

Scour, FABER, and flexion-adduction.

What imaging findings support hip OA?

Joint-space narrowing, osteophytes, and sclerosis.

What does a positive hip C-sign indicate?

Deep hip joint pain; not specific to one diagnosis.

How can rheumatoid arthritis differ from OA?

Systemic inflammatory disease; often bilateral with flares.

What early systemic symptoms can accompany hip RA?

Malaise, weakness, fatigue, and stiffness.

What is avascular necrosis of the femoral head?

Bone death caused by impaired blood supply.

What risk factors are listed for hip AVN?

Trauma, systemic steroids, alcohol, and sickle-cell disease.

What pain pattern suggests hip AVN?

Groin or proximal thigh pain with loading and eventually rest.

What gait pattern may occur with hip AVN?

Antalgic gait.

What symptoms are characteristic of a labral tear?

Groin pain, painful clicking, locking, or instability.

Where are most acetabular labral tears located?

Anterior or anterosuperior labrum.

What mechanisms may cause a hip labral tear?

Trauma, twisting, sports activity, or degeneration.

What hip ROM may occur with a labral tear?

Often near-normal ROM with pain at end range.

What does a positive anterior Fitzgerald test suggest?

Anterior acetabular labral pathology.

What does FABER to EADIR assess in Fitzgerald testing?

Anterior labrum.

What does EABER to FADIR assess in Fitzgerald testing?

Posterior labrum.

What may groin pain with axial compression and hip IR suggest?

Labral degeneration or tear.

What is femoroacetabular impingement (FAI)?

Abnormal femur-acetabulum contact from reduced joint clearance.

What is cam-type FAI?

Abnormal femoral head-neck shape causing impingement.

What is pincer-type FAI?

Excessive acetabular coverage causing impingement.

What test is associated with cam-type FAI?

FADIR.

What distinguishes FAI from labral tear?

FAI is abnormal bony contact; a tear is labral tissue damage.

What can cause intra-articular loose bodies?

Advanced OA or trauma.

What symptoms suggest loose bodies in the hip?

Mechanical catching, sudden pain, or giving way.

What end feel may suggest an intra-articular loose body?

Springy end feel during passive extension.

What is developmental dysplasia of the hip?

Abnormal hip joint development, often involving a shallow acetabulum.

What long-term changes may occur with hip dysplasia?

Subluxation, shallow acetabulum, and increased femoral anteversion.

What age group commonly develops SCFE?

Adolescents.

What is SCFE?

Displacement through the proximal femoral growth plate.

What gait and posture clues suggest SCFE?

Antalgic gait and externally rotated involved leg.

Which hip movements are limited with SCFE?

Flexion, internal rotation, and abduction.

Where can pain from SCFE be felt?

Groin, medial thigh, or knee.

What is the appropriate response to suspected SCFE?

Urgent medical referral; avoid weight bearing.

What is Legg-Calvé-Perthes disease?

Reduced blood supply to the developing femoral head.

What examination findings suggest Perthes disease?

Child with limp, limited IR/abduction, and possible Trendelenburg.

What is internal snapping hip?

Iliopsoas snapping over anterior hip structures.

What is external snapping hip?

ITB or gluteus maximus snapping over greater trochanter.

What may cause intra-articular snapping?

Labral tear or loose body.

What is athletic pubalgia?

Sports-related groin pain involving the lower abdominal wall.

What activities provoke athletic pubalgia?

Twisting, cutting, coughing, or sneezing.

What is a hip pointer?

Direct-blow contusion of the iliac crest near the ASIS.

What symptoms suggest meralgia paresthetica?

Anterolateral thigh numbness, burning, or abnormal sensation.

Which nerve is involved in meralgia paresthetica?

Lateral femoral cutaneous nerve.

What is piriformis syndrome in the lecture?

Sciatic nerve irritation or entrapment near piriformis.

What screening helps distinguish piriformis from lumbar symptoms?

Lumbar spine and neurological screening.

What findings suggest hip adductor strain?

Groin tenderness and pain with resisted adduction.

What findings suggest iliopsoas irritation?

Anterior groin pain with resisted hip flexion.

What findings suggest trochanteric bursitis?

Lateral hip tenderness and pain lying on that side.