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  • Ortho Project

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    The patient has pain in their posterior thigh and hip area that increases with sitting and activity. Physical examination found reduced range of motion and muscle weakness in the hip area. Two hypotheses were considered - referred pain from a low back problem or piriformis syndrome, but tests were negative. Examination of the hip found limited extension, tight muscles, a positive Ober test indicating tight iliopsoas, and reproduction of snapping with movement confirming snapping hip syndrome. The proposed treatment plan will include home exercises to address the snapping hip syndrome.

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    ortho project

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    The patient has pain in their posterior thigh and hip area that increases with sitting and activity. Physical examination found reduced range of motion and muscle weakness in the hip area. Two hypotheses were considered - referred pain from a low back problem or piriformis syndrome, but tests were negative. Examination of the hip found limited extension, tight muscles, a positive Ober test indicating tight iliopsoas, and reproduction of snapping with movement confirming snapping hip syndrome. The proposed treatment plan will include home exercises to address the snapping hip syndrome.

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    19 views2 pages

    Ortho Project

    Uploaded by

    api-557082548
    The patient has pain in their posterior thigh and hip area that increases with sitting and activity. Physical examination found reduced range of motion and muscle weakness in the hip area. Two hypotheses were considered - referred pain from a low back problem or piriformis syndrome, but tests were negative. Examination of the hip found limited extension, tight muscles, a positive Ober test indicating tight iliopsoas, and reproduction of snapping with movement confirming snapping hip syndrome. The proposed treatment plan will include home exercises to address the snapping hip syndrome.

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    © All Rights Reserved
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    of 2

    Functional hypothesis Physical examination results goals Proposed

    problems treatment plan


    including home
    exercises
    Cannot sit for pain pain assessment :(location, - Location: posterior
    long time nature, severity (VAS), aspect of thigh
    aggravating/relieving factors) -nature: electrical
    pain
    -severity: 7/10
    -
    aggravating/relieving
    factors: increased
    with sitting and
    relieved with
    standing.
    ( according to the pain
    assessment we
    thought of two
    hypothesis)
    Low back problem referred to -low back AROM -centralization with
    the thigh (classification -Repeated/sustained extension,
    system) movement peripheralization with
    -low back classification staging flexion
    (Oswestry scale) - centralization with
    -reevaluation from time to extension,
    time to re stage the patient at peripheralization with
    the classification system flexion FROM
    PRONE/STANDING
    -Stage 1- extension
    category
    Piriformis syndrome 1-passive internal rotation 1-negative: (no
    from sitting and prone difference in ROM
    between sitting and
    prone+ no
    reproduction of - -
    symptoms-electrical
    pain)
    2-Piriformis Test (flexibility 2- negative: no
    test) reproduction of
    symptoms-electrical
    pain
    Walking Pain 1-pain assessment :(location, 1- Location: anterior
    limitation severity (VAS), right hip pain
    aggravating/relieving factors) -severity: 5/10
    -aggravating/relieving
    factors: pain
    increased in physical
    2- symptoms coming with pain activity and is better
    with resting
    2- the patient
    reported hip snapping
    with movement- (this
    led us to thinking of
    snapping hip
    syndrome)
    Limited ROM AROM/PROM+END FEEL
    /goniometric measurement Limited extension
    ROM with muscle
    tightness end feel

    Muscle weakness MMT -hip abductor


    (Gluteus Medius)
    (3/5)
    -internal rotators
    (3/5)
    -external rotators
    (3/5)
    Hip pathology Intraarticular 1-FABER test 1-positive for tight
    (snapping hip snapping hip iliopsoas
    syndrome) syndrome 2- Anterior/Posterior labral 2-negative
    tear tests
    Extraarticular 1-Ober test 1-negative
    snapping hip 2-Thomas test 2-positive for tight
    syndrome 3-passive movements: from iliopsoas
    (internal vs flexion and external rotation 3-positive and
    external to extension and internal reproduce the snap
    snapping hip rotation (to test the presence (confirmed by
    syndrome?) of internal snapping hip) repeating the
    movement while
    applying pressure to
    iliopsoas tendon -no
    snapping)

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