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HIP (Femoral Acetabular Impingement (Non-contractile, History: pt will…
HIP
Femoral Acetabular Impingement
Non-contractile
History: pt will experience sharp/piercing pain in anterior groin area with twisting, squatting, flexing the hip; dull ache with rest; pain with prolonged sitting or walking
Pt may have Ant pelvic tilt, excessive lordosis, flexed trunk, limping
Look for TRENDELENBURG sign. as well as
C SIGN
D/D confirmation:
PROM-A, ST, PFT
AROM: limitation and pain with flex, ADD, IR
PROM C: limitation and pain with flex + IR, abnormal muscle guarding
PROM-A: hypomobile posteriorly with capsular tightness abnormal muscle guarding
Special Test: FADDIR, FABER (+ if reproduces symptoms or increased distance from unaffected side, SCOURING
Anterior Hip labrum tear
Interventions:
Structural inspection: anterior pelvic tilt, excessive lordosis, flexed trunk, limping
History: hx of trauma or after chronic impingement, limited rotation,
clicking, popping, catching
Deep dull ache in groin area with rest, sharp pain with twisting, squatting, flexing (pain in sitting, squatting, stairs)
AROM
: limitation and pain with flex, add and IR
NONCONTRACTILE
PROM-C
: limitation and pain with flex + IR w/capsular tightness or abnormal cartilage EF
PROM-A
hypomobile inferior glide with abnormal cartilage (soft EF with a 'crunch') or tight capsul, hypomobile posterior "stretch" with abnormal cartilage or tight joint capsule, distraction with normal capsular end-feel and improvement of symptomms
MLT
: tight hamstrings, may get false positives due to decreased motion
MMT
: Weak Glutes
Special test: FADDIR/Scouring
Hamstring Tendinopathy
Glute Med Tendinopathy
Trochanteric bursitis
Legg-Calve-Perthes
SCFE (slipped capital femoral epiphysis (anterior-lateral hip pain)
Snapping Hip
Knee