Tuberculosis Of Hip

Ans. is ‘a’ i.e., Flexion, abduction external rotation

Ans. is ‘b’ i.e., Painful hip gait

Antalgic gait is a limp adopted so as to avoid pain on weight bearing structures, characterized by very short stance phase.

Stance phase of the gait is shortened on the injured side to alleviate pain experienced when bearing weight on that side.

Ans. a. No loss of sensation

During hip replacement, loss of joint and ligament receptors leads to no loss of sensation.

“Loss of joint and ligament receptors during hip replacement is not associated with any loss of sensations; whereas during knee replacement can lead to loss of proprioception in the involved limb/s.”

“The joint position underlying proprioception and balance is based on input from various mechanoreceptors in the joint capsule and periarticular tendons and also from deep cutaneous receptors. Certain studies following first-generation total hip replacement reported insignificant loss of proprioceptive sensitivity in the operated hip; i.e. hip position did not depend on the bone section or type of implant used.”- Szymanski C, Thouvarecq R, Dujardin F, Migaud H, Maynou C and Girard J. Functional performance after hip resurfacing or total hip replacement: A comparative assessment with non-operated subjects. 2012;98 (1): 1-7

Ans. is ‘d’ i.e., All of the above

Transient synovitis of Hip

• Transient synovitis of hip is also known as observation hip, toxic synovitis or irritable hip. Its a self-limiting, inflammatory condition of the synovium, that lasts only a short time (therefore known as transient) It is the most common cause of hip pain and limp in children under 10 yrs of age. Cause is not known but association has been seen with a recent history of an upper respiratory tract infection.
• Presentation is with hip pain or limp. The limb is in attitude of slight flexion, abduction and external rotation. The child may have low grade fever. The ESR, C-Reactive protein & WBCs count are normal (This differentiates Transient synovitis from Septic arthiritis a serious condition, in which patient has high grade fever and elevated ESR, C-Reactive protein and WBC count). Radiograph or ultrasound may show widening of the joint space However, most of the time x-ray is normal.
• Usually the treatment of a clinically suspected case of transient synovitis of hip is Bed rest, NSAIDS and observation.
• USG guided aspiration is indicated for :-

1. Temperature > 99^.5° F
2. ESR > 20 (Raised ESR)
3. Severe hip pain with ROM