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Query: UNIPROT:P50502 (Hip)
 7,003 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Hip fractures in awake patients are rarely subtle in their clinical presentation. We report two cases of occult, comminuted, intertrochanteric hip fractures that occurred in awake, elderly patients who were brought to the emergency department for evaluation of other medical conditions. Neither patient complained of hip pain, and both were transported to the ED without spinal immobilization. Physical examination revealed no sign of hip fracture. Patient 1 was scheduled for admission and just prior to transfer out of the ED developed hip pain. Patient 2 was admitted for workup of possible transient ischemic attack and approximately 2.5 hours after admission complained of hip pain. Radiographs of both patients revealed comminuted intertrochanteric hip fractures. In an elderly, nonambulatory patient who may have fallen prior to evaluation, routine radiographs of the pelvis and hip should be performed followed by plain tomography, computed tomography, bone scan, or magnetic resonance imaging as indicated to rule out occult hip fracture. Even comminuted intertrochanteric hip fractures can present in an occult fashion; therefore, a high index of suspicion must be maintained for these injuries.
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PMID:Clinically occult presentation of comminuted intertrochanteric hip fractures. 144 54

The authors compared seven radiologic indices of hip osteoarthritis to establish which provided the best definition of the disease for epidemiologic purposes. Hip joints were assessed from intravenous urograms taken in a British hospital between 1982 and 1987 in 1,315 men aged 60-75 years. The indices examined were an overall qualitative grading of osteoarthritis, four measures of joint space, the maximum thickness of subchondral sclerosis, and the size of the largest osteophyte. Minimal joint space (i.e., the shortest distance between the femoral head margin and the acetabulum) was the index most strongly associated with other radiologic features of osteoarthritis. Among a subset of 759 men who answered a questionnaire about symptoms, the overall qualitative grading, minimal joint space, and thickness of subchondral sclerosis were the radiologic indices most predictive of hip pain. Within- and between-observer repeatability were tested in a subset of 50 subjects. Measures of joint space were more reproducible than other indices. These data suggest that, at least in men, minimal joint space is the best radiologic criterion of hip osteoarthritis for use in epidemiologic studies.
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PMID:Defining osteoarthritis of the hip for epidemiologic studies. 238 55

Hip and pelvic injuries are relatively rare in the young athlete. Contusions and musculotendinous sprains are the most common injuries about the hip and pelvis. Apophyseal avulsion fractures and stress fractures are the most frequently encountered skeletal injuries. Each of these entities can be successfully treated with guided physical therapy following conservative management with rest, anti-inflammatory medications, and ice massage until the patient is pain free. Epiphyseal, diaphyseal, or pathologic fractures are rare entities that are secondary to violent trauma. These injuries are severe and often require operative intervention. Femoral neck fractures have a high rate of complications from avascular necrosis, nonunion, or malunion. Pelvic fractures have frequent associated genitourinary, abdominal, neurologic, and musculoskeletal injuries. Pathologic fractures are most commonly secondary to benign lesions, such as unicameral bone cysts, and less likely owing to malignancy. Finally, in children with hip pain during athletic activities, even with antecedent trauma, the sports clinician must screen for slipped capital femoral epiphysis, Perthes' disease, congenital subluxation of the hip, toxic synovitis, systemic neoplasia, or infectious process.
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PMID:Hip and pelvic injuries in the young athlete. 304 59

A useful protocol for the evaluation of hip pain in the pediatric patient, using a combination of plain radiographs, hip ultrasound (US), and triple phase radionuclide bone scans is presented. Patients with hip pain were initially evaluated by plain radiographs of the pelvis and hips. If no diagnosis was reached, the hips were studied for effusions by real-time hip ultrasonography. If an effusion was present, the joint was aspirated for diagnosis. If no effusion was present by US or if no diagnosis was reached by aspiration, triple phase radionuclide bone scans were performed. Fifty patients were evaluated by this prospective protocol, and the diagnosis was reached in 48 of the 50 cases (10 by plain radiographs, 16 by US, and aspiration of the joint, and 22 by triple phase bone scans). Hip effusions were found in 20 patients by US, with no false positives or false negatives. Previous studies for detecting effusions by US have emphasized absolute measurements of the capsular width, but we report a typical appearance of the hip capsule when fluid is present (a bulging convex capsule). When no effusion is present, the capsule is concave and parallels the long axis of the femoral neck.
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PMID:A protocol of plain radiographs, hip ultrasound, and triple phase bone scans in the evaluation of the painful pediatric hip. 328 Feb 13

Two patients were evaluated for a complaint of long-standing hip pain. No etiology of their progressively disabling symptoms was found by routine diagnostic studies. Hip arthrography and arthrotomography in each case, however, demonstrated multiple intraarticular filling defects consistent with nonradiopaque loose bodies. These were subsequently confirmed at arthrotomy. Synovial chondromatosis is a rare disease in which intrasynovial cartilage metaplasia results in multiple intracapsular loose bodies. Its presence in plain radiographs is uncommon, but has been previously documented. This can account for frequent long delays in accurate diagnosis. Arthrography and/or arthrotomography, however, can be key diagnostic tools. They are recommended in the evaluation of patients whose relatively normal initial clinical examination, laboratory, and roentgenographic studies fail to adequately explain the presence of genuinely disabling symptoms.
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PMID:Synovial chondromatosis. 342 42

This report describes a new technique by which arthroscopy of the hip provides complete visualization of the joint space. The arthroscope and operative instruments are inserted by a direct lateral approach over the greater trochanter, with the patient in the lateral decubitus position. The involved leg is held in an abducted and flexed position with traction by pulleys hung overhead. Hip abduction and flexion relaxes the capsule and traction separates the joint so that insertion of the arthroscope is facilitated. Arthroscopic examination of the hip joint was performed in 11 patients. The indications for surgery included diagnosis of unresolved hip pain following failure of conservative treatment, removal of loose bodies, exploration and debridement following fracture and/or dislocation, and evaluation of the arthritic hip prior to definitive surgery.
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PMID:Hip arthroscopy by the lateral approach. 2036 35

A 3-year old boy with an acute onset of hip pain and limitation of motion had 4 mm of crescent shaped intra-articular gas produced by manual traction radiography. Hip aspiration produced more than 2 ml of fluid from the hip. Manual traction radiography producing the vacuum phenomenon with release of crescent shaped intra-articular gas did not exclude joint fluid in this patient.
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PMID:Hip joint fluid in the presence of the vacuum phenomenon. 395 6

Bursae or abscess cavities communicating with the hip joint were demonstrated by hip arthrography or by computed tomography (CT) in 40 cases. The bursae or abscess cavities were associated with underlying abnormalities in the hip, including painful hip prostheses, infection, and inflammatory or degenerative arthritis. Structures communicating with the joint capsule included iliopsoas bursae (13 cases), bursae associated with the greater trochanter (21 cases), ischiotrochanteric bursae created by abnormal articulation between the ischium and lesser trochanter (two cases), and abscess cavities not associated with a bursa (four cases). Symptoms may be produced directly as a result of infection or indirectly as a result of inflammation or pressure on adjacent structures. In cases of suspected infection, direct puncture and aspiration of the bursa or abscess cavity, in addition to joint aspiration, may be necessary to obtain organisms for culture as joint aspiration may not yield fluid. Hip arthrography can confirm a diagnosis of bursae and abscess cavities communicating with the hip joint in patients with hip pain or soft-tissue masses around the groin. Differentiation of enlarged bursae from other abnormalities is important to avoid unnecessary or incorrect surgery.
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PMID:Bursae and abscess cavities communicating with the hip. Diagnosis using arthrography and CT. 401 91

Results of revision of 24 resurfacing hip prostheses followed up for a minimum of one year are encouraging. The average Iowa Hip Rating after salvage was higher than the average highest rating prior to failure of the original resurfacing procedure. There were no intraoperative complications in revising any of the failed resurfacing procedures. Results of revision of the failed component of a resurfacing procedure are comparable with those of conversion to a conventional hip arthroplasty. Thorough, prompt evaluation of hip pain in recipients of a hip resurfacing procedure is necessary for preservation of remaining bone stock. In comparison to revision of conventional hip arthroplasty, revision of failed resurfacing hip arthroplasty is technically easier and has a better prognosis in providing the patient with a pain-free, functional hip.
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PMID:Analysis of revision surgery of resurfacing hip arthroplasty. 712 64

Injuries to the hip are commonly encountered by orthopedic surgeons and will, for the most part, respond well to conservative therapy. When a patient's hip pain has not responded to the appropriate treatment and radiographic measurements have not shown any specific pathology, arthroscopy of the hip can be a valuable diagnostic and therapeutic procedure. We retrospectively reviewed 94 consecutive patients who experienced refractory hip pain that persisted longer than 6 months (average: 2.1 years) and who had an average follow up of 2.5 years. Statistical analysis was performed using Fisher's Exact Test (P value) and Pearson (r value) correlation coefficient to compare preoperative symptomatology and physical examination findings with intraoperative pathology. Statistically significant results were obtained when comparing preoperative symptoms of a painful hip click and mechanical symptoms of locking with acetabular labral injuries (P = .000, r = .896) and loose bodies (P = .000, r = .896), respectively. Radiologic studies were nondiagnostic in 76% of patients in this series. Hip arthroscopy can be a valuable and viable procedure in the diagnosis and treatment of protracted or progressive hip pain lasting more than 6 months.
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PMID:The role of hip arthroscopy in the diagnosis and treatment of hip disease. 747 16


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