Pelvis and Thigh Pathologies
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| Hip Pointer | Hematoma and/or inflammation of the tensor fascia latae on the ilium due to a compressive force
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| Hip Pointer Identifying Information | Caused by a direct blow to the ASIS. Graded 1-3, 3 being most severe. Abnormal gait, bruising over the ilium, swelling, posture is slightly flexed forward. Impairment of muscles having an insertion or origin along the iliac crest.
Special Tests: None
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| Hip Pointer Differential Diagnosis | Ilium fracture, muscle strain (gluteus medius, gluteus minimus, internal oblique, external oblique), avulsion fracture, bursitis.
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| Trochanteric Bursitis | Irritation of the trochanteric bursa due to a compressive force.
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| Trochanteric Bursitis Identifying Information | Acute or insidious. Pain over the greater trochanter. Tenderness over the trochanteric bursa during palpation. Possible crepitus during AROM.
Special Tests: Ober's test for ITB tightness.
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| Trochanteric Bursitis Differential Diagnosis | Tendinopathy, femoral neck stress fx, contusion, gluteus medius strain, TFL strain.
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| Femoral Neck Stress Fx | Stress fx at the neck of the femur due to compressive or tensile loads.
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| Femoral Neck Stress Fx Identifying Information | Insidious onset. Pain in the femoral triangle relieved by rest. Antalgic gait may be present. Possible point tenderness w/ palpation. Limitations with AROM and PROM. MMT w/in normal limits.
Special Tests: Active SLR (+) and Hip Scouring
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| Femoral Neck Stress Fx Differential Diagnosis | Synovitis, labral tears, neoplasm, strains, avascular necrosis, arthritis.
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| Labral Tear | Tearing of the acetabular labrum.
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| Labral Tear Identifying Information | Acute or degenerative onset. Pain most common in the anterior or medial hip. Possible clicking or popping with motion. Pain with AROM and PROM. MMT is w/in normal limits.
Special Tests: Hip scouring (+), Thomas test (+), Trendelenburg (+)
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| Labral Tear Differential Diagnosis | Hernia, athletic pubalgia, osteitis pubis, adductor strain, snapping hip syndrome, osteochondral defect.
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| Snapping Hip Syndrome | Palpable and audible snap occurs within the hip joint during flexion and extension.
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| Snapping Hip Syndrome Identifying Information | Insidious onset. Pain and discomfort associated with the snapping; localized over the greater trochanter. Snapping may be palpable over the anterior hip for internal and over the greater trochanter for external.
Special Tests: None
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| Snapping Hip Syndrome Differential Diagnosis | Trochanteric bursitis, iliopsoas bursitis, intra-articular lesion, chronic positional subluxation of the coxofemoral joint.
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| Piriformis Syndrome | Inflamed sciatic nerved caused by an irritated or inflamed piriformis muscle.
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| Piriformis Syndrome Identifying Information | Acute or insidious onset. Pain increases with standing and decreases with the pt lying supine with knees flexed. Atrophy of the gluteus maximus may be evident. Tenderness over the sciatic notch during palpation.
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| Piriformis Syndrome Identifying Information | Deep pain in the posterior aspect of the hip. Pain with AROM, MMT, and PROM.
Special Tests: SLR, Resisted hip abduction in seated position.
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| Piriformis Syndrome Differential Diagnosis | Nerve root compression, nerve root impingement, sciatica, disc herniation.
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