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  /Title (6002-hip.pdf)
  /Creator (Cheatography)
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  /Subject (6002 Hip Cheat Sheet)
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    \vspace{-2pt}\large{\bf{\textcolor{DarkBackground}{\textrm{6002 Hip Cheat Sheet}}}} \\
    \normalsize{by \textcolor{DarkBackground}{bee.f (bee.f)} via \textcolor{DarkBackground}{\uline{cheatography.com/180201/cs/42419/}}}
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  \mymulticolumn{2}{p{5.377cm}}{\bf\textcolor{white}{Cheatographer}}  \\
  \vspace{-2pt}bee.f (bee.f) \\
  \uline{cheatography.com/bee-f} \\
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  \mymulticolumn{1}{p{5.377cm}}{\bf\textcolor{white}{Cheat Sheet}}  \\
   \vspace{-2pt}Published 26th February, 2024.\\
   Updated 23rd February, 2024.\\
   Page {\thepage} of \pageref{LastPage}.
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\begin{tabularx}{17.67cm}{x{7.7715 cm} x{9.4985 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Osteitis Pubis}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{• {\bf{GREEN}}} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
• {\bf{Intro:}} & - Non-infectious idiopathic, inflammatory condition of the pubic symphysis \& surrounding structures\{\{nl\}\}- Results in groin / lower abdominal px\{\{nl\}\}- Multiple causes, likely related to overuse / trauma\{\{nl\}\}- Association w/ surgery: 1st described in pts who had undergone suprapubic surgery, remains a complication of invasive procedures around the pelvis\{\{nl\}\}- Can occur as an inflammatory process in athletes\{\{nl\}\}- Incidence of 0.5-0.8\% in athletes, w/ higher incidence in distance runners \& athletes in kicking sports\{\{nl\}\}- M\textgreater{}F (3:1) \tn 
% Row Count 26 (+ 25)
% Row 2
\SetRowColor{LightBackground}
• {\bf{Aetiology (risk factors):}} & - Fibular-acetabular impingement (FAI)\{\{nl\}\}- Pregnancy / childbirth\{\{nl\}\}- High-level of athletic activity {\emph{(athletic pubalgia)}}\{\{nl\}\}- Urological / gynaecological surgery\{\{nl\}\}- Trauma\{\{nl\}\}- Psoriatic arthritis\{\{nl\}\}- Ankylosing spondylitis \tn 
% Row Count 38 (+ 12)
\end{tabularx}
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\begin{tabularx}{17.67cm}{x{7.7715 cm} x{9.4985 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Osteitis Pubis (cont)}}  \tn
% Row 3
\SetRowColor{LightBackground}
• {\bf{Pathophysiology:}} & - Stress injury affecting the peri-symphyseal pubic bones due to increased strain on the anterior pelvis\{\{nl\}\}- Pubic symphysis, a non-synovial amphiarthrodial joint, has minimal motion normally due to a static ligamentous complex\{\{nl\}\}- Pubic symphysis is where rectus abdominis inserts \& the adductor complex originates\{\{nl\}\}- Antagonistic actions of the rectus abdominis (elevates symphysis) \& adductors (depressing the joint)create conditions osteitis pubis development through chronic tendinosis\{\{nl\}\}- Chronic muscle imbalance leads to abnormal forces on the pubic symphysis, causing instability, pubic bone stress reaction, \& eventual hyaline cartilage degeneration\{\{nl\}\}- Alternative theory: osteitis results from increased compensatory motion across the joint due to limited motion elsewhere in the kinetic chain ({\emph{FAI}}) \tn 
% Row Count 38 (+ 38)
\end{tabularx}
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\begin{tabularx}{17.67cm}{x{7.7715 cm} x{9.4985 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Osteitis Pubis (cont)}}  \tn
% Row 4
\SetRowColor{LightBackground}
• {\bf{Clinical presentation:}} & - Waddling antalgic gait or crepitus\{\{nl\}\}- Px localised over the symphysis \& radiating outward\{\{nl\}\}- Anterior \& medial groin px\{\{nl\}\}- Gradual onset\{\{nl\}\}- Adductor px / lower abdominal px that then localises to the pubic area\{\{nl\}\}- Aggravated during turning, walking, coughing, sneezing, lying on one side, \& walking up or down stairs\{\{nl\}\}- Commonly tenderness around the pubic symphysis \& pubic ramus, along w/ painful muscle spasms in the adductor region \tn 
% Row Count 21 (+ 21)
% Row 5
\SetRowColor{white}
• {\bf{Physical examination:}} & +ve palpation, Spring test of pubic symphysis, Adductor squeeze test \tn 
% Row Count 25 (+ 4)
% Row 6
\SetRowColor{LightBackground}
• {\bf{Diagnosis:}} & - In early stages, plain radiographs may appear normal\{\{nl\}\}- Chronic case: pubic symphysis demonstrates lytic changes, sclerosis, sub-chondral resorption, bony margin irregularities \& widening\{\{nl\}\}- Dynamic instability of the pubic symphysis (\textgreater{}2mm of subluxation) can be observed on frog-leg view \tn 
% Row Count 39 (+ 14)
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\begin{tabularx}{17.67cm}{x{7.7715 cm} x{9.4985 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Osteitis Pubis (cont)}}  \tn
% Row 7
\SetRowColor{LightBackground}
• {\bf{Complications:}} & - Chronic px\{\{nl\}\}- Infection\{\{nl\}\}- Non-union fusion\{\{nl\}\}- Recurrence\{\{nl\}\}- Scrotal / labial swelling \tn 
% Row Count 5 (+ 5)
% Row 8
\SetRowColor{white}
• {\bf{Management:}} & - Approx. 3 - 6 month recovery time (conservative care)\{\{nl\}\}- RICE, NSAIDs, (steroid) injections\{\{nl\}\}- Surgery \tn 
% Row Count 11 (+ 6)
% Row 9
\SetRowColor{LightBackground}
• {\bf{Ddx:}} & - Athletic pubalgia\{\{nl\}\}- FAI\{\{nl\}\}- Osteomyelitis\{\{nl\}\}- Adductor strain\{\{nl\}\}- Rectus abdominus strain\{\{nl\}\}- SIJ dysfunction\{\{nl\}\}- GU disease \tn 
% Row Count 18 (+ 7)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{\{\{popup="https://www.ncbi.nlm.nih.gov/books/NBK556168/"\}\}link text\{\{/popup\}\}; \{\{popup="https://www.physio-pedia.com/Osteitis\_Pubis"\}\}link text\{\{/popup\}\}}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}--}
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\begin{tabularx}{17.67cm}{x{7.7715 cm} x{9.4985 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Transient Osteoporosis of the Hip (TOH)}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{• {\bf{YELLOW}}} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
• {\bf{Intro:}} & - Idiopathic \& self-limiting disorder that causes temporary bone loss of the proximal femur\{\{nl\}\}- Characterised by unexplained hip px\{\{nl\}\}- Associated w/ ↓ ROM, non-specific labs, \& mostly uncertain radiographic findings \tn 
% Row Count 12 (+ 11)
% Row 2
\SetRowColor{LightBackground}
• {\bf{Aetiology (risk factors):}} & - Mainly affects the hip joint, but can also affect knee, ankle, \& foot\{\{nl\}\}- M\textgreater{}F (esp, 30-60 yrs)\{\{nl\}\}- Also more common in women in late stages of pregnancy (last 3 months) or who have recently given birth \tn 
% Row Count 22 (+ 10)
% Row 3
\SetRowColor{white}
• {\bf{Pathophysiology:}} & - Not clear understanding\{\{nl\}\}- Blockage of small blood vessels that surround the hip\{\{nl\}\}- Hormonal changes\{\{nl\}\}- Abnormal stresses (external load \& force) on the bone \tn 
% Row Count 30 (+ 8)
\end{tabularx}
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\begin{tabularx}{17.67cm}{x{7.7715 cm} x{9.4985 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Transient Osteoporosis of the Hip (TOH) (cont)}}  \tn
% Row 4
\SetRowColor{LightBackground}
• {\bf{Clinical presentation:}} & - Sudden onset of px, usually anterior thigh, groin, lateral hip, or buttocks\{\{nl\}\}- Px that intensifies w/ weight bearing \& may lessen w/ rest\{\{nl\}\}- No previous accident or injury to the hip that would trigger px\{\{nl\}\}- Slightly limited motion (gentle hip movement usually pxless)\{\{nl\}\}- Px that gradually increases over a period of weeks or months \& may be disabling\{\{nl\}\}- Noticeable limp due to guarding \tn 
% Row Count 19 (+ 19)
% Row 5
\SetRowColor{white}
• {\bf{Physical examination:}} & - ↓ ROM (AROM feels worse)\{\{nl\}\}- Severe px when wight bearing (min px w/ PROM) \tn 
% Row Count 23 (+ 4)
% Row 6
\SetRowColor{LightBackground}
• {\bf{Diagnosis:}} & {\bf{X-ray:}}\{\{nl\}\}- Early stage (first 6 weeks) of the disease may exhibit slight decrease in bone density (challenging to detect)\{\{nl\}\}- Several months later, may reveal significant loss of bone density, w/ femoral head nearly disappearing\{\{nl\}\}{\bf{Nuclear medicine bone scan:}}\{\{nl\}\}- Can more clearly show changes in the bone\{\{nl\}\}{\bf{DEXA:}}\{\{nl\}\}- Not useful in Dx of TOH \tn 
% Row Count 40 (+ 17)
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\begin{tabularx}{17.67cm}{x{7.7715 cm} x{9.4985 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Transient Osteoporosis of the Hip (TOH) (cont)}}  \tn
% Row 7
\SetRowColor{LightBackground}
• {\bf{Complications:}} & - Fractures\{\{nl\}\}- Joint collapse\{\{nl\}\}- Chronic px\{\{nl\}\}- 2° OA\{\{nl\}\}- Recurrence\{\{nl\}\}- Functional impairment \tn 
% Row Count 6 (+ 6)
% Row 8
\SetRowColor{white}
• {\bf{Management:}} & - NSAIDs\{\{nl\}\}- Weight-bearing restriction\{\{nl\}\}- Strengthening \& flexibility\{\{nl\}\}- Water exrcises\{\{nl\}\}- Mobs / drops\{\{nl\}\}- Proper nutrition (vitamin D \& calcium) \tn 
% Row Count 14 (+ 8)
% Row 9
\SetRowColor{LightBackground}
• {\bf{Ddx:}} & - Osteoporosis\{\{nl\}\}- AVN\{\{nl\}\}- RA\{\{nl\}\}- Stress fracture\{\{nl\}\}- Bone marrow oedema\{\{nl\}\}- Osteomyelitis\{\{nl\}\}- Hip lapral tear\{\{nl\}\}- Refered px from Lx disorders \tn 
% Row Count 22 (+ 8)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{\{\{popup="https://orthoinfo.aaos.org/en/diseases-{}-conditions/transient-osteoporosis-of-the-hip/\#:\textasciitilde{}:text=Transient\%20osteoporosis\%20of\%20the\%20hip\%20is\%20a\%20rare\%20condition\%20that,or\%20other\%20weight\%2Dbearing\%20activities."\}\}link text\{\{/popup\}\}}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}--}
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\begin{tabularx}{17.67cm}{x{7.7715 cm} x{9.4985 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Transient Synovitis (TS)}}  \tn
% Row 0
\SetRowColor{LightBackground}
• {\bf{YELLOW}} & Refer to GP if pt starts showing red flags / isn't improving \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
• {\bf{Intro:}} & - Acute, non-specific, inflammatory process affecting joint synovium\{\{nl\}\}- Common cause of hip pain in paediatric population\{\{nl\}\}- Benign, self-limiting process\{\{nl\}\}- Must differentiate TS from an acute infectious process\{\{nl\}\}- Most common in children 3- 10 yrs old\{\{nl\}\}- Incidence estimated to be 0.2\%, w/ total lifetime risk of 3\%\{\{nl\}\}- M\textgreater{}F (4:1) \tn 
% Row Count 20 (+ 17)
% Row 2
\SetRowColor{LightBackground}
• {\bf{Aetiology (risk factors):}} & - Preceding upper respiratory infection (URI)\{\{nl\}\}- Preceding bacterial infection\{\{nl\}\}- Post-streptococcal toxic synovitis\{\{nl\}\}- Preceding trauma\{\{nl\}\}- Alternative theory: post-vaccine or drug-mediated hypersensitivity reactions \& certain allergic predispositions \tn 
% Row Count 33 (+ 13)
\end{tabularx}
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\begin{tabularx}{17.67cm}{x{7.7715 cm} x{9.4985 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Transient Synovitis (TS) (cont)}}  \tn
% Row 3
\SetRowColor{LightBackground}
• {\bf{Pathophysiology:}} & - Pathological cascade involves non-specific inflammation targeting synovial joint lining, leading to hypertrophic changes\{\{nl\}\}- Clinical Hx may reveal one or multiple risk factors \tn 
% Row Count 9 (+ 9)
% Row 4
\SetRowColor{white}
• {\bf{Clinical presentation:}} & - Acute unilateral limb disuse\{\{nl\}\}- Non-specifc hip px, subtle limp, refusal to bear weight\{\{nl\}\}- Hx may show increased agitation or more frequent crying than baseline\{\{nl\}\}- Recent Hx of URI, pharyngitis, bronchitis, or otitis media (supports TS diagnosis) \tn 
% Row Count 21 (+ 12)
% Row 5
\SetRowColor{LightBackground}
• {\bf{Physical examination:}} & - Mildly ↓ ROM, especially ABduction \& INternal rot.\{\{nl\}\}- Pts may exhibit hip flexion, abduction, \& external rotation position to alleviate intra-articular pressure\{\{nl\}\}- 1/3 of pts may have normal ROM\{\{nl\}\}- Provocative tests: +ve basic log roll or FABER test (px on ipsilateral anterior side indicates hip disorder, while px on the contralateral side around the sacroiliac joint suggests SIJ dysfunction) \tn 
% Row Count 40 (+ 19)
\end{tabularx}
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\begin{tabularx}{17.67cm}{x{7.7715 cm} x{9.4985 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Transient Synovitis (TS) (cont)}}  \tn
% Row 6
\SetRowColor{LightBackground}
• {\bf{Diagnosis:}} & {\bf{Imaging:}}\{\{nl\}\}- Radiographs: useful for excluding bony lesions unless onset of Ssx is within 3 days, no fever, child appears well, \& has mildly restricted abduction w/o guarding against movement in other planes\{\{nl\}\}- Ultrasound: extremely accurate for detecting infra capsular effusion, doesn't help to determine the cause (used to guide hip aspiration)\{\{nl\}\}- MRI: useful in settings where routine aspiration is not performed to differentiate TS from septic arthritis\{\{nl\}\}{\bf{Labs:}}\{\{nl\}\}- Complete blood cell (CBC) count\{\{nl\}\}- Erythrocyte sedimentation rate (ESR)\{\{nl\}\}- C-reactive protein measurement\{\{nl\}\}- Urinalysis \& cultures \tn 
% Row Count 29 (+ 29)
% Row 7
\SetRowColor{white}
• {\bf{Complications:}} & -Recurrence of Ssx, in approx. 20-25\% of pts (usually between 6 months) \tn 
% Row Count 33 (+ 4)
\end{tabularx}
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\begin{tabularx}{17.67cm}{x{7.7715 cm} x{9.4985 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Transient Synovitis (TS) (cont)}}  \tn
% Row 8
\SetRowColor{LightBackground}
• {\bf{Management:}} & - Rest, NSAIDs, heat \&/or massage\{\{nl\}\}- In case of clinical concern, pt admission fro observation is considered\{\{nl\}\}- General improvement after 24-48 hours\{\{nl\}\}- Complete resolution may take 1-2 weeks (75\% of pts)\{\{nl\}\}- If significant Ssx last for 7-10 days, consider alternative Ddx\{\{nl\}\}- If Ssx last longer than a month, pt may have alternative pathology \tn 
% Row Count 17 (+ 17)
% Row 9
\SetRowColor{white}
• {\bf{Ddx:}} & - Coxa magna\{\{nl\}\}- Osteomyelitis\{\{nl\}\}- Septic arthritis\{\{nl\}\}- 1° or metastatic lesions\{\{nl\}\}- Legg-Calve-Perthes disease (LCPD)\{\{nl\}\}- Slipped capital femoral epiphysis (SCFE)\{\{nl\}\}- Others: Lyme arthritis, pyogenic sacroiliitis, \& juvenile RA \tn 
% Row Count 29 (+ 12)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{\{\{popup="https://www.ncbi.nlm.nih.gov/books/NBK459181/"\}\}link text\{\{/popup\}\}; \{\{popup="https://emedicine.medscape.com/article/1007186-overview\#a2"\}\}link text\{\{/popup\}\}}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}--}
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\begin{tabularx}{17.67cm}{x{7.7715 cm} x{9.4985 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Slipped Upper Femoral Epiphysis (SUFE)}}  \tn
% Row 0
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\mymulticolumn{2}{x{17.67cm}}{• {\bf{YELLOW}}} \tn 
% Row Count 1 (+ 1)
% Row 1
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• {\bf{Intro:}} & - Most common hip pathology in pre-adolescents \& adolescents\{\{nl\}\}- Also known as {\emph{slipped upper femoral epiphysis}} (SUFE) \tn 
% Row Count 7 (+ 6)
% Row 2
\SetRowColor{LightBackground}
• {\bf{Aetiology (risk factors):}} & - Idiopathic w/ no Hx of trauma or injury before Ssx onset\{\{nl\}\}- Associated w/ endocrine disorders such as hyper/hypothyroidism, , growth hormone deficiency, renal disorders, \& Down syndrome\{\{nl\}\}- Hypothyroidism is most common cause of non-idiopathic SCFE\{\{nl\}\}- Pre-adolescent \& adolescent pts (10.8/100,000)\{\{nl\}\}- Obesity is single most significant risk factor\{\{nl\}\}- M\textgreater{}F\{\{nl\}\}- Periods of rapid growth\{\{nl\}\}- Prior hip radiation therapy\{\{nl\}\}- retroversion of the acetabulum or femoral head\{\{nl\}\}- Average age of onset is F 11.2 \& M 12.0 \tn 
% Row Count 32 (+ 25)
\end{tabularx}
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\begin{tabularx}{17.67cm}{x{7.7715 cm} x{9.4985 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Slipped Upper Femoral Epiphysis (SUFE) (cont)}}  \tn
% Row 3
\SetRowColor{LightBackground}
• {\bf{Pathophysiology:}} & - Uncertain mechanism\{\{nl\}\}- High physiological axial load on a weak physis\{\{nl\}\}- Obesity increase mechanical weight \& force, while endocrine / renal disorders may weaken the physis\{\{nl\}\}- Slippage occurs at the hypertrophic zone of physis\{\{nl\}\}- Epiphysis stays in the acetabulum, \& metaphysis EX rots w/ anterior translation\{\{nl\}\}- SCFE is a Salter-Harris type I fracture \tn 
% Row Count 17 (+ 17)
% Row 4
\SetRowColor{white}
• {\bf{Clinical presentation:}} & - Atraumatic Hx\{\{nl\}\}- Hip, thigh, groin, knee px\{\{nl\}\}- Limping \& inability to WB\{\{nl\}\}- 4-5 months Ssx prior to Dx\{\{nl\}\}- Sitting w/ affected leg crossed over the other relieves px \tn 
% Row Count 26 (+ 9)
% Row 5
\SetRowColor{LightBackground}
• {\bf{Physical examination:}} & - ↓ ROM (esp. IR, FLEX, ABD)\{\{nl\}\}- Drehmann sign\{\{nl\}\}- Trendelenburg sign\{\{nl\}\}- Atrophy. of surrounding muscles \tn 
% Row Count 32 (+ 6)
\end{tabularx}
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\begin{tabularx}{17.67cm}{x{7.7715 cm} x{9.4985 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Slipped Upper Femoral Epiphysis (SUFE) (cont)}}  \tn
% Row 6
\SetRowColor{LightBackground}
• {\bf{Diagnosis:}} & - Recent studies suggest US may be more sensitive that radiographs\{\{nl\}\}- {\bf{X-rays:}} Epiphysis widening or growth plate lucency \& blurring of proximal femoral metaphysis due to overlap on the displaced epiphysis \tn 
% Row Count 10 (+ 10)
% Row 7
\SetRowColor{white}
• {\bf{Complications:}} & - AVN\{\{nl\}\}- Chondrolysis\{\{nl\}\}- FAI\{\{nl\}\}- Slip progression \tn 
% Row Count 13 (+ 3)
% Row 8
\SetRowColor{LightBackground}
• {\bf{Management:}} & - Mainly operative\{\{nl\}\}- NSAIDs (px management)\{\{nl\}\}- Strengthening \tn 
% Row Count 17 (+ 4)
% Row 9
\SetRowColor{white}
• {\bf{Ddx:}} & - Septic arthritis\{\{nl\}\}- Osteomyelitis\{\{nl\}\}- Traumatic fracture\{\{nl\}\}- Sprain\{\{nl\}\}- Strain\{\{nl\}\}- LCPD\{\{nl\}\}- Osgood Schlatter disease \tn 
% Row Count 24 (+ 7)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
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\mymulticolumn{2}{x{17.67cm}}{\{\{popup="https://www.ncbi.nlm.nih.gov/books/NBK538302/\#:\textasciitilde{}:text=Slipped\%20capital\%20femoral\%20epiphysis\%20(slipped,the\%20femoral\%20head\%20and\%20neck."\}\}link text\{\{/popup\}\}}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}--}
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\begin{tabularx}{17.67cm}{x{7.7715 cm} x{9.4985 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Snapping Hip / Coxa Saltans}}  \tn
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\mymulticolumn{2}{x{17.67cm}}{• {\bf{GREEN}}} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
• {\bf{Intro:}} & - Audible or palpable snapping sensation during hip joint movement\{\{nl\}\}- Affects 5-10\% of the population\{\{nl\}\}- F\textgreater{}M\{\{nl\}\}- Common when engaging in repetitive extreme hip motions, e.g. ballet dancers (in 80\%), weight lifters, soccer players, \& runners\{\{nl\}\}{\bf{Extra-articular snapping hip:}}\{\{nl\}\}- Iliotibial band moving over the greater trochanter during hip flexion, extension, \& rotation\{\{nl\}\}- Proximal hamstring tendon rolling over the ischial tuberosity\{\{nl\}\}- Fascia late or anterior aspect of gluteus Maximus rolling over the greater trochanter\{\{nl\}\}- Psoas tendon rolling over the medial fibres of the iliac muscle\{\{nl\}\}- Combination of defects, e.g. thickening of both the posterior iliotibial band \& anterior glute max\{\{nl\}\}{\bf{Intra-articular snapping hip:}}\{\{nl\}\}- Iliopsoas tendon snapping over iliopectinal eminence or anterior femoral head\{\{nl\}\}- Parabola cysts\{\{nl\}\}- Partial or complete bifurcation of the iliopsoas tendon\{\{nl\}\}- {\bf{Differentiation from intra-articular pathology:}} close physical exams \& imaging; approx. 50\% of internal snapping hip cases also have an additional intra-articular hip pathology identified \tn 
% Row Count 53 (+ 52)
\end{tabularx}
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\begin{tabularx}{17.67cm}{x{7.7715 cm} x{9.4985 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Snapping Hip / Coxa Saltans (cont)}}  \tn
% Row 2
\SetRowColor{LightBackground}
• {\bf{Aetiology (risk factors):}} & - Often caused by overuse but can also be triggered by trauma, e.g. intramuscular injection or surgical procedures\{\{nl\}\}- Coxa vera after total hip arthroplasty is linked to external snapping hip syndrome\{\{nl\}\}- Anatomical variations: increased distance between greater trochanters, prominent greater trochanters, \& narrow bi-iliac width\{\{nl\}\}- Iliotibial band tightness, shorter muscle or tendon lengths, muscle tightness, or inadequate muscle relaxation \tn 
% Row Count 21 (+ 21)
% Row 3
\SetRowColor{white}
• {\bf{Pathophysiology:}} & {\bf{External:}}\{\{nl\}\}- Caused by iliotibial band snapping over the greater trochanter of the femoral head\{\{nl\}\}- During movements like flexion, extension, \& external rotation\{\{nl\}\}{\bf{Internal:}}\{\{nl\}\}- Caused by iliopsoas tendon snapping over bony prominences\{\{nl\}\}- Bone prominences include the iliopectinal eminence or the anterior aspect of the femoral head \tn 
% Row Count 38 (+ 17)
\end{tabularx}
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\begin{tabularx}{17.67cm}{x{7.7715 cm} x{9.4985 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Snapping Hip / Coxa Saltans (cont)}}  \tn
% Row 4
\SetRowColor{LightBackground}
• {\bf{Clinical presentation:}} & - Prevalence of snapping hip\{\{nl\}\}- Location of the snap\{\{nl\}\}- Timing of the snap\{\{nl\}\}- Age/duration of onset\{\{nl\}\}- Px / disability\{\{nl\}\}- Impact on ADLs \tn 
% Row Count 8 (+ 8)
% Row 5
\SetRowColor{white}
• {\bf{Physical examination:}} & {\bf{External:}}\{\{nl\}\}- +ve Ober's test: tight iliotibial band\{\{nl\}\}- FABER test: iliotibial band snapping\{\{nl\}\}{\bf{Internal:}}\{\{nl\}\}- FABER test: iliopsoas snapping\{\{nl\}\}- Stinchfield test: anterior groin px\{\{nl\}\}- Thomas test: tight hip flexors\{\{nl\}\}- Iliopsoas stress test: abdominal px \tn 
% Row Count 21 (+ 13)
% Row 6
\SetRowColor{LightBackground}
• {\bf{Diagnosis:}} & - Plain radiograph (not acurate), used to rule out anatomical variations, developmental dysplasia, or other hip pathology\{\{nl\}\}{\bf{External:}}\{\{nl\}\}- T1 weighted axial MRI: thickened ITB or thickened anterior edge of glute max\{\{nl\}\}- Dynamic ultrasonography (if not visible on exam): demonstrates snapping of ITB over the greater trochanter, \& can also reveal associated {\emph{tendonitis, iliopsoas bursitis, or muscle tears}}\{\{nl\}\}{\bf{Internal:}}\{\{nl\}\}- Magnetic resonance orthography: comprehensively identifies both the SHS \& accompanying pathologies\{\{nl\}\}- Iliopsoas bursography\{\{nl\}\}- Fluoroscopy\{\{nl\}\}- Dynamic ultrasonography \tn 
% Row Count 50 (+ 29)
\end{tabularx}
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\begin{tabularx}{17.67cm}{x{7.7715 cm} x{9.4985 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Snapping Hip / Coxa Saltans (cont)}}  \tn
% Row 7
\SetRowColor{LightBackground}
• {\bf{Management:}} & - RICE\{\{nl\}\}- NSAIDs\{\{nl\}\}- Steroid injections\{\{nl\}\}- Activity modifications\{\{nl\}\}- Release: TFL, glute medius, glute max, \& adductors\{\{nl\}\}- Activate: abductors\{\{nl\}\}- STW\{\{nl\}\}- SMT\{\{nl\}\}- Mobs / drops \tn 
% Row Count 10 (+ 10)
% Row 8
\SetRowColor{white}
• {\bf{Ddx:}} & - Acetabular labral tear\{\{nl\}\}- Bursitis: greater trochanter / iliopsoas\{\{nl\}\}- Femoral head AVN\{\{nl\}\}- Hip tendonitis\{\{nl\}\}- Iliopsoas tendinitis\{\{nl\}\}- ITB syndrome\{\{nl\}\}- Intra-articular loose body of the hip\{\{nl\}\}- Synovitis \tn 
% Row Count 21 (+ 11)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{\{\{popup="https://www.ncbi.nlm.nih.gov/books/NBK448200/"\}\}link text\{\{/popup\}\}; \{\{popup="https://www.physio-pedia.com/Snapping\_Hip\_Syndrome"\}\}link text\{\{/popup\}\}}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
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\begin{tabularx}{17.67cm}{x{7.7715 cm} x{9.4985 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Meralgia Paraesthetica}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{• {\bf{GREEN}}} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
• {\bf{Intro:}} & - Also known as Bernhardt Roth syndrome, lateral femoral cutaneous n. (LFCN) syndrome / neuralgia\{\{nl\}\}- Associated with LFCN compression\{\{nl\}\}- Purely sensory nerve\{\{nl\}\}- Vulnerable to compression during its course from Lx-Sx plexus to inguinal ligament\{\{nl\}\}- Passes into subcutaneous tissue of anterior thigh, involving px \& dysethesia \tn 
% Row Count 17 (+ 16)
% Row 2
\SetRowColor{LightBackground}
• {\bf{Aetiology (risk factors):}} & - Slightly more common F\textgreater{}M\{\{nl\}\}- Common in military\{\{nl\}\}- Most common 40-50 yrs\{\{nl\}\}- Pregnant \& obese pts have increased risk\{\{nl\}\}- 3-4 / 10,000\{\{nl\}\}- Carpal tunnel syndrome associated w/ an ↑ risk of meralgia paraesthetica\{\{nl\}\}{\bf{Spontaneous causes:}}\{\{nl\}\}- Diabetes mellitus\{\{nl\}\}- Lead poisoning\{\{nl\}\}- Alcohol abuse\{\{nl\}\}- Hypothyroidism\{\{nl\}\}{\bf{Mechanical causes:}}\{\{nl\}\}- External direct pressure from tight seat belts, belts, or restrictive clothing\{\{nl\}\}- Increased intra-abdominal pressure from obesity, pregnancy, or tumours\{\{nl\}\}- Leg length discrepancy\{\{nl\}\}- Degenerative changes of pubic symphysis\{\{nl\}\}- Rare bone tumour near the iliac crest\{\{nl\}\}{\bf{Iatrogenic causes:}}\{\{nl\}\}- Surgeries of surrounding areas \tn 
% Row Count 51 (+ 34)
\end{tabularx}
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\begin{tabularx}{17.67cm}{x{7.7715 cm} x{9.4985 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Meralgia Paraesthetica (cont)}}  \tn
% Row 3
\SetRowColor{LightBackground}
• {\bf{Pathophysiology:}} & - Derives from posterior divisions of L2/L3 spinal nerves\{\{nl\}\}- Lateral psoas → under iliac fascia → crosses anterior iliacus m. → ASIS → anterior \& posterior divisions pass under / through / above the inguinal ligament\{\{nl\}\}- Anterior: sensory to anterior thigh-knee\{\{nl\}\}- Posterior: sensory to lateral thigh-greater trochanter\{\{nl\}\}- External compression or internal pressure (obesity, pregnancy, tumours)\{\{nl\}\}- Surgical injury during the nerve's passage\{\{nl\}\}- Metabolic causes like diabetes (injury may result from swelling due to ↓ axoplasmic transport), alcohol or lead poisoning \tn 
% Row Count 28 (+ 28)
% Row 4
\SetRowColor{white}
• {\bf{Clinical presentation:}} & - Unilateral Ssx of upper lateral thigh\{\{nl\}\}- Burning px, paraesthesia, hyperaesthesia\{\{nl\}\}- Subacute onset over days to weeks\{\{nl\}\}- Pts often point to or rub outer thigh (potential loss of hair from rubbing)\{\{nl\}\}- Ssx don't change w/ position\{\{nl\}\}- Aggravated by prolonged hip EX (waking, rising from seated position)\{\{nl\}\}- May be relieved by hip flexion (sitting)\{\{nl\}\}- Hx of tight clothing, trauma, weight-gain, pregnancy \tn 
% Row Count 48 (+ 20)
\end{tabularx}
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\begin{tabularx}{17.67cm}{x{7.7715 cm} x{9.4985 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Meralgia Paraesthetica (cont)}}  \tn
% Row 5
\SetRowColor{LightBackground}
• {\bf{Physical examination:}} & - Pelvic compression test (side-lying on unaffected side)\{\{nl\}\}- Meralgia paraesthetica test\{\{nl\}\}- Sensory changes (pin-prick, light touch) \tn 
% Row Count 7 (+ 7)
% Row 6
\SetRowColor{white}
• {\bf{Diagnosis:}} & - Radiographs are not required\{\{nl\}\}- May consider blood tests if metabolic etiology \tn 
% Row Count 11 (+ 4)
% Row 7
\SetRowColor{LightBackground}
• {\bf{Complications:}} & - Result from surgical transection of LFCM, leading to permanent anaesthesia (sensory loss) \tn 
% Row Count 16 (+ 5)
% Row 8
\SetRowColor{white}
• {\bf{Management:}} & - Benign, self-limiting\{\{nl\}\}- Often spontaneous remission\{\{nl\}\}- Pt reassurance \& education\{\{nl\}\}- Reducing pressure \& irritation (weight-loss)\{\{nl\}\}- Icing\{\{nl\}\}- SMT\{\{nl\}\}- NSAIDs\{\{nl\}\}- Abdominal exercises\{\{nl\}\}- Injection\{\{nl\}\}- Surgical decompression\{\{nl\}\}- {\bf{Other:}} pulsed radiofrequency n, ablation, electroacupuncture, K-taping \tn 
% Row Count 32 (+ 16)
\end{tabularx}
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\begin{tabularx}{17.67cm}{x{7.7715 cm} x{9.4985 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Meralgia Paraesthetica (cont)}}  \tn
% Row 9
\SetRowColor{LightBackground}
• {\bf{Ddx:}} & - Lx radiculopathy\{\{nl\}\}- Abdominal masses\{\{nl\}\}- Pelvic tumour\{\{nl\}\}- Metastasis of iliac crest\{\{nl\}\}- Avulsion fracture\{\{nl\}\}- Hip OA\{\{nl\}\}- Chronic appendicitis \tn 
% Row Count 8 (+ 8)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{\{\{popup="https://www.ncbi.nlm.nih.gov/books/NBK557735/"\}\}link text\{\{/popup\}\}; \{\{popup="https://www.physio-pedia.com/Meralgia\_Paraesthetica"\}\}link text\{\{/popup\}\}}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
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\begin{tabularx}{17.67cm}{x{7.7715 cm} x{9.4985 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Legg-Calve-Perthes Disease (LCPD)}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{• {\bf{YELLOW}}} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
• {\bf{Intro:}} & - Idiopathic osteonecrosis of capital femoral epiphysis of femoral head occurring in the paediatric population\{\{nl\}\}- Also known as {\emph{coxa plana}} \tn 
% Row Count 8 (+ 7)
% Row 2
\SetRowColor{LightBackground}
• {\bf{Aetiology (risk factors):}} & - Cause is unknown, possibly idiopathic or related to factors disrupting blood flow (key factor in development of LCPD) to femoral epiphysis\{\{nl\}\}- Bilateral in 10\%-20\% cases (asymmetrical due to different stages)\{\{nl\}\}- Causes include: trauma (macro or repetitive micro), coagulopathy (in about 75\% of pts), \& steroid use\{\{nl\}\}- Thrombophilia is found in approx. 50\% of pts\{\{nl\}\}- 3-12 yrs old (highest occurrence at 5-7 yo)\{\{nl\}\}- 1 in 1200 children \textless{}15 yo\{\{nl\}\}- M\textgreater{}F (5:1)\{\{nl\}\}{\bf{Risk factors:}} Caucasian / Asian heritage, HIV, low socioeconomic status, birth weight \textless{}2.5kg, secondhand smoke exposure \tn 
% Row Count 36 (+ 28)
\end{tabularx}
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\begin{tabularx}{17.67cm}{x{7.7715 cm} x{9.4985 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Legg-Calve-Perthes Disease (LCPD) (cont)}}  \tn
% Row 3
\SetRowColor{LightBackground}
• {\bf{Pathophysiology:}} & {\bf{Usually 4 phases:}}\{\{nl\}\}{\bf{1. Necrosis:}} disruption of blood supply → infarction of femoral capital epiphysis (esp. subchondral cortical bone) → growth of ossific nucleus stops → infarcted bone softens \& dies\{\{nl\}\}{\bf{2. Fragmentation:}} body reabsorbs the infarcted bone\{\{nl\}\}{\bf{3. Reossification:}} Osteoblastic activity → femoral epiphysis reestablished\{\{nl\}\}{\bf{4. Remodelling:}} new femoral head (enlarged \& flattened) → reshaping occurs during growth → healing (if responding to conservative c.) takes 2-4 yrs \tn 
% Row Count 24 (+ 24)
% Row 4
\SetRowColor{white}
• {\bf{Clinical presentation:}} & - Limp of acute / insidious onset, often painless (1-3 months)\{\{nl\}\}- Px (if present) localised to hip or referred to the knee, thigh, or abdomen\{\{nl\}\}- With progression, px typically worsens with activity\{\{nl\}\}- No systemic findings should be found \tn 
% Row Count 36 (+ 12)
\end{tabularx}
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\begin{tabularx}{17.67cm}{x{7.7715 cm} x{9.4985 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Legg-Calve-Perthes Disease (LCPD) (cont)}}  \tn
% Row 5
\SetRowColor{LightBackground}
• {\bf{Physical examination:}} & - ↓ IR \& ABD of hip\{\{nl\}\}- Px on rot. referred to the anteromedial thigh \&/or knee\{\{nl\}\}- Atrophy of thighs \& buttock from px leading to disuse\{\{nl\}\}- Leg length discrepancy\{\{nl\}\}- Trendelenburg sign: weak abductors (glute med \& min)\{\{nl\}\}- Antalgic gait (acute): short-stance phase 2° to px in the weight-bearing leg\{\{nl\}\}- Trendelenburg gait (chronic): downward pelvic tilt away from the affected hip during swing phase \tn 
% Row Count 20 (+ 20)
% Row 6
\SetRowColor{white}
• {\bf{Diagnosis:}} & - Labs are used to exclude other diagnoses\{\{nl\}\}{\bf{Imaging:}}\{\{nl\}\}- Early radiographs can be normal\{\{nl\}\}- Plain films are preferred\{\{nl\}\}- Standard A-P pelvis \& frog-leg views\{\{nl\}\}- If in doubt or plain films are normal, DEXA scan or MRI\{\{nl\}\}{\bf{Early findings:}}\{\{nl\}\}- Epiphyseal cartilage hypertrophy\{\{nl\}\}- Epiphysis appears smaller or denser\{\{nl\}\}- "Crescent sign"\{\{nl\}\}{\bf{Late findings:}}\{\{nl\}\}- Mushroom head \& snow cap\{\{nl\}\}- DEXA shows decreased perfusion of the femoral head\{\{nl\}\}- MRI shows marrow changes \tn 
% Row Count 44 (+ 24)
\end{tabularx}
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\begin{tabularx}{17.67cm}{x{7.7715 cm} x{9.4985 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Legg-Calve-Perthes Disease (LCPD) (cont)}}  \tn
% Row 7
\SetRowColor{LightBackground}
• {\bf{Complications:}} & - Coxa magna (widening) \& coxa plana (flattening)\{\{nl\}\}- Damaged femoral head can result in premature physical arrest, causing leg length discrepancy\{\{nl\}\}- Poorly formed femoral can lead to acetabular dysplasia \& hip incongruency\{\{nl\}\}- Hip incongruence can alter mechanics, causing labral tears\{\{nl\}\}- Complications like lateral hip subluxation or extrusion can result in lifelong problems\{\{nl\}\}- Late complication: arthritis \tn 
% Row Count 20 (+ 20)
% Row 8
\SetRowColor{white}
• {\bf{Management:}} & - {\bf{Goals:}} px \& Ssx management, restoration of ROM, \& containment of femoral head in acetabulum\{\{nl\}\}- Activity restriction \& protective weight-bearing until ossification is complete\{\{nl\}\}- NSAIDs\{\{nl\}\}- STW\{\{nl\}\}- Surgery \tn 
% Row Count 31 (+ 11)
\end{tabularx}
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\begin{tabularx}{17.67cm}{x{7.7715 cm} x{9.4985 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Legg-Calve-Perthes Disease (LCPD) (cont)}}  \tn
% Row 9
\SetRowColor{LightBackground}
• {\bf{Ddx:}} & - Infectious etiology including septic arthritis, osteomyelitis, pericapsular pyomyositis\{\{nl\}\}- Transient synovitis\{\{nl\}\}- Multiple epiphyseal dysplasia (MED)\{\{nl\}\}- Spondyloepiphyseal dysplasia (SED)\{\{nl\}\}- Sickle cell disease\{\{nl\}\}- Gaucher disease\{\{nl\}\}- Hypothyroidism\{\{nl\}\}- Meyers dysplasia \tn 
% Row Count 14 (+ 14)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{\{\{link="https://www.ncbi.nlm.nih.gov/books/NBK513230/"\}\}link text\{\{/link\}\}; \{\{link="https://www.physio-pedia.com/Legg-Calve-Perthes\_Disease"\}\}link text\{\{/link\}\}}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
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\begin{tabularx}{17.67cm}{x{7.7715 cm} x{9.4985 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Acetabular Labral Tear (A/PLT) / Loose Body}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{• {\bf{YELLOW}}} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
• {\bf{Intro:}} & - Involves the cartilage ring (labrum) around the outside rim of the hip joint socket\{\{nl\}\}- Labrum cushions the hip joint \& acts as a rubber seal, securing the thighbone within the hip socket \tn 
% Row Count 10 (+ 9)
% Row 2
\SetRowColor{LightBackground}
• {\bf{Aetiology (risk factors):}} & - Most tears occur in anterosuperior quadrant\{\{nl\}\}- Posterosuperior tears are more common in Asian population due to hyeprflexion or squatting motions\{\{nl\}\}- Occur between 8-72 yrs (highest incidence in 50 yrs)\{\{nl\}\}- F\textgreater{}M\{\{nl\}\}- 22-55\% pts w/ hip/groin px have an ALT\{\{nl\}\}- Up to 74\% of ALTs have no specific casue\{\{nl\}\}- Trauma \& sports-related causes\{\{nl\}\}- Individuals attending gym 3x/week have an ↑ risk of developing ALT \tn 
% Row Count 30 (+ 20)
\end{tabularx}
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\begin{tabularx}{17.67cm}{x{7.7715 cm} x{9.4985 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Acetabular Labral Tear (A/PLT) / Loose Body (cont)}}  \tn
% Row 3
\SetRowColor{LightBackground}
• {\bf{Pathophysiology:}} & {\bf{Five common mechanisms:}}\{\{nl\}\}- Femoroacetabular impingement (FAI)\{\{nl\}\}- Trauma: mis-stepping, running w/ hyperextension, or EX rot\{\{nl\}\}- Capsular laxity: cartilage disorders (e.g. Ehlers-Danlos syndrome) or rotational laxity from excessive EX rot (ballet, hockey, gymnastics)\{\{nl\}\}- Hip dysplasia\{\{nl\}\}- Degenerative changes \tn 
% Row Count 15 (+ 15)
% Row 4
\SetRowColor{white}
• {\bf{Clinical presentation:}} & - Anterior hip / groin px\{\{nl\}\}- ALT indicated by buttock px; while PLT are less common\{\{nl\}\}- Clicking, popping, giving way, catching, \& stiffness\{\{nl\}\}- Dull ache often ↑ w/ activities (running, brisk walk, twisting, \& climbing stairs)\{\{nl\}\}- Specific manoeuvres causing groin px: 1) FX, ADD, IR fro ALT 2) Passive hyper EXT, ABD, EXT rot for PLT\{\{nl\}\}- Functional limitations: prolonged sitting, walking, climbing stairs, running, \& twisting/pivoting\{\{nl\}\}- Ssx can persist for long duration (average \textgreater{}2 yrs)\{\{nl\}\}- Traumatic onset associated w/ an audible pop or sensation of subluxation \tn 
% Row Count 42 (+ 27)
\end{tabularx}
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\begin{tabularx}{17.67cm}{x{7.7715 cm} x{9.4985 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Acetabular Labral Tear (A/PLT) / Loose Body (cont)}}  \tn
% Row 5
\SetRowColor{LightBackground}
• {\bf{Physical examination:}} & - FX knee gait \& shortened step length on affected leg\{\{nl\}\}- Anterior hip-impingement test (FAIR) or posterior impingement test\{\{nl\}\}- FABER test\{\{nl\}\}- Resisted SLR\{\{nl\}\}- Leg-roll test \tn 
% Row Count 9 (+ 9)
% Row 6
\SetRowColor{white}
• {\bf{Diagnosis:}} & - MR arthrogram preferred over MRI \& plain radiograph \tn 
% Row Count 12 (+ 3)
% Row 7
\SetRowColor{LightBackground}
• {\bf{Complications:}} & - Recurrence\{\{nl\}\}{\bf{Post-surgical:}}\{\{nl\}\}- DVT\{\{nl\}\}- Articular damage\{\{nl\}\}- Neuromuscular injury \tn 
% Row Count 17 (+ 5)
% Row 8
\SetRowColor{white}
• {\bf{Management:}} & - NSAIDs\{\{nl\}\}- 10-12 week protocol\{\{nl\}\}- Reduce WB\{\{nl\}\}- Injection\{\{nl\}\}- Strengthening\{\{nl\}\}- SMT\{\{nl\}\}- Surgery \tn 
% Row Count 23 (+ 6)
% Row 9
\SetRowColor{LightBackground}
• {\bf{Ddx:}} & - Contusion (esp. over bony prominences)\{\{nl\}\}- Strains\{\{nl\}\}- Athletic pubalgia\{\{nl\}\}- Osteitis pubis\{\{nl\}\}- Inflammatory arthritides (RA)\{\{nl\}\}- Piriformis syndrome\{\{nl\}\}- SHS\{\{nl\}\}- Bursitis(trochanteric, ischiogluteal, iliopsoas)\{\{nl\}\}- OA of femoral head\{\{nl\}\}- AVN\{\{nl\}\}- Septic arthritis\{\{nl\}\}- Fracture or dislocation\{\{nl\}\}- Tumours\{\{nl\}\}- Hernia (inguinal or femoral)\{\{nl\}\}- SCFE\{\{nl\}\}- LCPD\{\{nl\}\}- Referred px from Lx-Sx or SIJ regions \tn 
% Row Count 44 (+ 21)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{\{\{popup="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2697339/"\}\}link text\{\{/popup\}\}; \{\{popup="https://www.physio-pedia.com/Hip\_Labral\_Disorders"\}\}link text\{\{/popup\}\}}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
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\begin{tabularx}{17.67cm}{x{7.7715 cm} x{9.4985 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Hernias (sports \& inguinal)}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{• {\bf{YELLOW}}} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
• {\bf{Intro:}} & - Protrusion of intestines through a weak spot in the abdominal muscles\{\{nl\}\}- Lump may disappear when pt lies down \& can sometimes be manually pushed out\{\{nl\}\}- Coughing may cause the hernia to reappear, indicating the temporary nature \tn 
% Row Count 12 (+ 11)
% Row 2
\SetRowColor{LightBackground}
• {\bf{Aetiology (risk factors):}} & - Lifting heavy object w/o stabilising abdominal muscles\{\{nl\}\}- Diarrhea or constipation\{\{nl\}\}- Family Hx (4x more likely)\{\{nl\}\}- Persistent coughing or sneezing\{\{nl\}\}- Obesity, poor nutrition, \& smoking (weaken muscles)\{\{nl\}\}- Pregnancy (low risk)\{\{nl\}\}- Injury: most sports-related hernias occur in the groin \& don't appear as a bulge (if untreated, can evolve into an inguinal hernia)\{\{nl\}\}- Common surgery\{\{nl\}\}- Peaks at 5 yo \& \textgreater{}70 yo\{\{nl\}\}- M\textgreater{}F (9:1) \tn 
% Row Count 33 (+ 21)
\end{tabularx}
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\begin{tabularx}{17.67cm}{x{7.7715 cm} x{9.4985 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Hernias (sports \& inguinal) (cont)}}  \tn
% Row 3
\SetRowColor{LightBackground}
• {\bf{Pathophysiology:}} & - Congenital \& acquired component\{\{nl\}\}- Higher type III collagen compared to type I \tn 
% Row Count 4 (+ 4)
% Row 4
\SetRowColor{white}
• {\bf{Clinical presentation:}} & - Bulging in groin area\{\{nl\}\} - Px / burning / pinching sensation in groin area\{\{nl\}\}- Can radiate into scrotum or down the leg\{\{nl\}\}- Can be aggravated by activity or coughing \tn 
% Row Count 12 (+ 8)
% Row 5
\SetRowColor{LightBackground}
• {\bf{Physical examination:}} & - Palpable bulge\{\{nl\}\}- If no bulge, ask pt to cough while palpating inguinal area \tn 
% Row Count 16 (+ 4)
% Row 6
\SetRowColor{white}
• {\bf{Diagnosis:}} & - Usually used when body habits makes physical exam limited\{\{nl\}\}- Ultrasound\{\{nl\}\}- CT scan\{\{nl\}\}- MRI \tn 
% Row Count 21 (+ 5)
% Row 7
\SetRowColor{LightBackground}
• {\bf{Complications:}} & - Hernia recurrence\{\{nl\}\}- Chronic px \tn 
% Row Count 23 (+ 2)
% Row 8
\SetRowColor{white}
• {\bf{Management:}} & - Monitor hernia\{\{nl\}\}- Wearing a truss (supportive undergarment that holds it in place)\{\{nl\}\}- NSAIDs\{\{nl\}\}- Reduce pressure off the tissue (e.g. address breathing mechanics)\{\{nl\}\}- Strengthen supportive tissue (deep core)\{\{nl\}\}- Reduce aggravating activities\{\{nl\}\}- Surgery (very common) \tn 
% Row Count 37 (+ 14)
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{x{7.7715 cm} x{9.4985 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Hernias (sports \& inguinal) (cont)}}  \tn
% Row 9
\SetRowColor{LightBackground}
• {\bf{Ddx:}} & - Lymphadenopathy\{\{nl\}\}- Lymphoma\{\{nl\}\}- Metastatic neoplasm\{\{nl\}\}- Hydrocele\{\{nl\}\}- Epididymitis\{\{nl\}\}- Testicular torsion\{\{nl\}\}- Abscess\{\{nl\}\}- Hematoma\{\{nl\}\}- Femoral artery aneurysm \tn 
% Row Count 9 (+ 9)
% Row 10
\SetRowColor{white}
{\bf{Sport hernia:}} & - Weakness in the inguinal canal's posterior wall\{\{nl\}\}- Nerve irritation \& px occur at the tendon insertion to the bone\{\{nl\}\}- Expansion of the transversals fascia at its weakest point\{\{nl\}\}- Enlargement of the inguinal triangle results from the fascia expansion\{\{nl\}\}- Rectus abdominis moves upward \& inward due to enlargement\{\{nl\}\}- Increased tension on the pubis is noted, potentially leading to tears\{\{nl\}\}- Bulging may compress the genital branch of the genitofemoral n.\{\{nl\}\}- Contribution to chronic px \tn 
% Row Count 33 (+ 24)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{\{\{popup="https://www.ncbi.nlm.nih.gov/books/NBK513332/"\}\}link text\{\{/popup\}\}; \{\{popup="https://www.physio-pedia.com/Hernia"\}\}link text\{\{/popup\}\}; \{\{popup="https://www.physio-pedia.com/Pubalgia"\}\}link text\{\{/popup\}\}}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{x{7.7715 cm} x{9.4985 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Piriformis Syndrome}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{• {\bf{GREEN}}} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
• {\bf{Intro:}} & - Sciatica nerve entrapment at the ischial tuberosity, presenting w/ radicular px\{\{nl\}\}- Piriformis m. is an EXT rot of the hip\{\{nl\}\}- Conditions that {\bf{mimic}} it: Lx canal stenosis, disc inflammation, or pelvic causes \tn 
% Row Count 11 (+ 10)
% Row 2
\SetRowColor{LightBackground}
• {\bf{Aetiology (risk factors):}} & - Accounts for 0.3-6\% of all cases of LBP \&/or sciatica\{\{nl\}\}- Annual incidence approx. 2.4 million cases\{\{nl\}\}- Middle aged pts\{\{nl\}\}- F\textgreater{}M (6:1) \tn 
% Row Count 18 (+ 7)
% Row 3
\SetRowColor{white}
• {\bf{Pathophysiology:}} & {\bf{Function of piriformis:}}\{\{nl\}\}- EXT rot during hip extension\{\{nl\}\}- Acts as a hip adductor during hip FX\{\{nl\}\}{\bf{Issues \& consequences:}}\{\{nl\}\}- Overuse, irritation, or inflammation of piriformis m. → leads to irritation of adjacent sciatica n. → sciatica n. entrapment may occur anterior to piriformis muscle or posterior to gemelli-obturator interns complex\{\{nl\}\}{\bf{Causes of piriformis stress:}}\{\{nl\}\}- Chronic poor body posture\{\{nl\}\}-Acute injury resulting in sudden \& strong IR of the hip \tn 
% Row Count 41 (+ 23)
\end{tabularx}
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\begin{tabularx}{17.67cm}{x{7.7715 cm} x{9.4985 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Piriformis Syndrome (cont)}}  \tn
% Row 4
\SetRowColor{LightBackground}
• {\bf{Clinical presentation:}} & - Chronic px in buttock \& hip area\{\{nl\}\}- Px when getting out of bed\{\{nl\}\}- Inability to sit for prolonged periods\{\{nl\}\}- Butt px worsened by hip movements\{\{nl\}\}- Ssx resembling sciatica\{\{nl\}\}- Difficulty differentiating radicular px due to 2° spinal stenosis vs piriformis s.\{\{nl\}\}- Radiating px into posterior thigh, occasionally lower leg at dermatomes L5 \& S1 \tn 
% Row Count 17 (+ 17)
% Row 5
\SetRowColor{white}
• {\bf{Physical examination:}} & - Mild-moderate tenderness around sciatica notch\{\{nl\}\}- FAIR test\{\{nl\}\}- Limited SLR\{\{nl\}\}- No neurological deficits\{\{nl\}\}- Sometimes limp when walking\{\{nl\}\}- Shortened \& EXT rot leg when supine ({\emph{splayfoot}}) \tn 
% Row Count 27 (+ 10)
% Row 6
\SetRowColor{LightBackground}
• {\bf{Diagnosis:}} & - US\{\{nl\}\}- MRI\{\{nl\}\}- CT\{\{nl\}\}- EMG \tn 
% Row Count 29 (+ 2)
% Row 7
\SetRowColor{white}
• {\bf{Complications:}} & {\bf{Related to surgery:}}\{\{nl\}\}- Nerve injury (sciatica)\{\{nl\}\}- Infection\{\{nl\}\}- Bleeding \tn 
% Row Count 33 (+ 4)
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{x{7.7715 cm} x{9.4985 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Piriformis Syndrome (cont)}}  \tn
% Row 8
\SetRowColor{LightBackground}
• {\bf{Management:}} & - Diagnosis of exclusion\{\{nl\}\}- NSAIDs\{\{nl\}\}- Muscle relaxants\{\{nl\}\}- Injections\{\{nl\}\}- Mobs\{\{nl\}\}- SMT\{\{nl\}\}- STW\{\{nl\}\}- Stretching\{\{nl\}\}- Surgery \tn 
% Row Count 7 (+ 7)
% Row 9
\SetRowColor{white}
• {\bf{Ddx:}} & - Lx canal stenosis\{\{nl\}\}- Disc inflammation\{\{nl\}\}- Hamstring injury\{\{nl\}\}- Lx-Sx facet syndrome\{\{nl\}\}- Lx radiculopathy\{\{nl\}\}- Spondylolisthesis / spondylosis\{\{nl\}\}- SIJ dysfunction\{\{nl\}\}- Inferior gluteal artery aneurysm\{\{nl\}\}- Tumour\{\{nl\}\}- Arteriovenous malformation \tn 
% Row Count 20 (+ 13)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{x{7.7715 cm} x{9.4985 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Femoroacetabular Impingement (FAI)}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{• {\bf{GREEN}}} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
• {\bf{Intro:}} & - Hip px due to mechanical impingement from abnormal hip morphology\{\{nl\}\}- Involves proximal femur \&/or acetabulum\{\{nl\}\}- Soft tissue damage in the FA joint results from extreme hip rotation or repetitive abnormal contact between bony prominences\{\{nl\}\}- Degenerative changes \& OA may develop in the long-term of this abnormal contact \tn 
% Row Count 17 (+ 16)
% Row 2
\SetRowColor{LightBackground}
• {\bf{Aetiology (risk factors):}} & - Still under investigation\{\{nl\}\}- Genetic factors may contribute to abnormal hip pathology\{\{nl\}\}- ↑ incidence in young athletes (males) due to {\bf{{\emph{cam deformity}}}} formation\{\{nl\}\}- Can occur in pts w/ a Hx of SCFE or LCPD\{\{nl\}\}-SCFE can cause a residual deformity even after surgical fixation, leading to an impingement\{\{nl\}\}- High prevalence in asymptomatic pts\{\{nl\}\}- Increased awareness → higher Dx rate throughout every. age \tn 
% Row Count 37 (+ 20)
\end{tabularx}
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\begin{tabularx}{17.67cm}{x{7.7715 cm} x{9.4985 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Femoroacetabular Impingement (FAI) (cont)}}  \tn
% Row 3
\SetRowColor{LightBackground}
• {\bf{Pathophysiology:}} & - FAI syndrome is associated w/ 3 hip joint morphology variations: cam, pincer, \& a combination\{\{nl\}\}- {\bf{Cam:}} flattening or convexity of femoral head-neck junction, common in young athletic men\{\{nl\}\}- {\bf{Pincer:}} "overcoverage" of moral head by acetabulum, more common in women\{\{nl\}\}- Isolated cam or pincer morphology insufficient for FAI syndrome Dx\{\{nl\}\}- {\bf{Combination:}} often associated w/ SCFE (85\% of pts)\{\{nl\}\}- Cam \& pincer morphologies can damage articular cartilage \& labrum due to impingement, causing FAI Ssx\{\{nl\}\}{\bf{Other factors}} contributing to FAI:\{\{nl\}\}- Weakness of deep hip muscles compromising stability, leading to increased joint loading\{\{nl\}\}- Repeated loading of labrum causing up regulation of nociceptive receptors \tn 
% Row Count 34 (+ 34)
\end{tabularx}
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\begin{tabularx}{17.67cm}{x{7.7715 cm} x{9.4985 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Femoroacetabular Impingement (FAI) (cont)}}  \tn
% Row 4
\SetRowColor{LightBackground}
• {\bf{Clinical presentation:}} & - Gradual onset of hip px, worsened by hip FX \& IR\{\{nl\}\}- Activities like high-intensity sports, squatting, driving, \& prolonged sitting aggravate\{\{nl\}\}- Acute hip px warrants workup for other potential causes\{\{nl\}\}{\bf{Key inquiries:}} trauma, infection, SCFE, LCPD, hip dysplasia, osteonecrosis, sporting activities, \& other hip pathologies\{\{nl\}\}- Groin \& anterolateral hip px, radiating to thigh, often with a "C sign" gesture indicating px location\{\{nl\}\}{\bf{Associated complaints:}} clicking, popping, \& catching, suggesting a possible labral injury \tn 
% Row Count 25 (+ 25)
% Row 5
\SetRowColor{white}
• {\bf{Physical examination:}} & - Trendelenburg air or abductor lurch suggests abductor muscle weakness or insufficiency\{\{nl\}\}- ↓ ROM, especially FX \& IR\{\{nl\}\}- FABER test: often +ve due to impingement-related labrum tear\{\{nl\}\}- +ve FAIR \& posterior impingement test\{\{nl\}\}- +ve IROP test \tn 
% Row Count 37 (+ 12)
\end{tabularx}
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\begin{tabularx}{17.67cm}{x{7.7715 cm} x{9.4985 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Femoroacetabular Impingement (FAI) (cont)}}  \tn
% Row 6
\SetRowColor{LightBackground}
• {\bf{Diagnosis:}} & - X-ray initially\{\{nl\}\}- CT or MR arthrogram for better appreciation of morphology of the hip / associated cartilage \& labral lesions \tn 
% Row Count 7 (+ 7)
% Row 7
\SetRowColor{white}
• {\bf{Complications:}} & - Associated w/ surgery\{\{nl\}\}{\bf{Major:}}\{\{nl\}\}- Femoral neck fracture: risk increases w/ excess reaction of a cam lesion\{\{nl\}\}- Abdominal compartment syndrome:during hip arthroscopy\{\{nl\}\}- Other: PE, deep joint infection, AVN, postoperative complication\{\{nl\}\}{\bf{Minor:}}\{\{nl\}\}- Hematoma\{\{nl\}\}- DVT\{\{nl\}\}- Numbness \& discomfort of lateral thigh\{\{nl\}\}- Temporary perineal numbness\{\{nl\}\}- Dyspareunia\{\{nl\}\}- Superficial infection\{\{nl\}\}- Heterotopic ossification \tn 
% Row Count 28 (+ 21)
% Row 8
\SetRowColor{LightBackground}
• {\bf{Management:}} & - Adaptation of ADLs to a safe ROM\{\{nl\}\}- Strengthening\{\{nl\}\}- SMT / hip distraction\{\{nl\}\}- Strengthening\{\{nl\}\}- NSAIDs\{\{nl\}\}- Steroid injections\{\{nl\}\}- Surgery \tn 
% Row Count 36 (+ 8)
\end{tabularx}
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\begin{tabularx}{17.67cm}{x{7.7715 cm} x{9.4985 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Femoroacetabular Impingement (FAI) (cont)}}  \tn
% Row 9
\SetRowColor{LightBackground}
• {\bf{Ddx:}} & - Trochanteric bursitis\{\{nl\}\}- Athletic pubalgia\{\{nl\}\}- Snapping hip syndrome\{\{nl\}\}- Flexor muscle strain\{\{nl\}\}- Hip subluxation\{\{nl\}\}- Soft tissue tumour\{\{nl\}\}- Femoral neck stres fracture\{\{nl\}\}- Septic arthritis\{\{nl\}\}- Osteomyelitis\{\{nl\}\}- Soft tissue infection\{\{nl\}\}- Osteonecrosis\{\{nl\}\}- Lx radiculopathy\{\{nl\}\}- Inguinal hernia\{\{nl\}\}- Hip OA \tn 
% Row Count 16 (+ 16)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{\{\{popup="https://www.ncbi.nlm.nih.gov/books/NBK547699/\#article-37128.s10"\}\}link text\{\{/popup\}\}; \{\{popup="https://www.physio-pedia.com/Femoroacetabular\_Impingement"\}\}link text\{\{/popup\}\}}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Disordered Hip Complex}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{- {\bf{Hypertonic iliopsoas}}} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{- Starts w/ a muscular imbalance\{\{nl\}\}- Most likely due to sedentary lifestyle\{\{nl\}\}- Creates new muscular strains, ligamentous \& capsular sprains \& fascial tension} \tn 
% Row Count 5 (+ 4)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{- Psoas pulls femur into FX \& EXT rot\{\{nl\}\}- Hip joint I spilled anterior \& superiorly\{\{nl\}\}- Considerable increase in intracapsular pressure of the hip joint\{\{nl\}\}- Directly related to degenerative changes in the hip\{\{nl\}\}- Limits pelvic sway} \tn 
% Row Count 10 (+ 5)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{- Hip \& groin px\{\{nl\}\}- Possible referral into anterior-medial thigh\{\{nl\}\}- LBP} \tn 
% Row Count 12 (+ 2)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{- Modified Thomas test} \tn 
% Row Count 13 (+ 1)
% Row 5
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{- Passive stretching\{\{nl\}\}- TrPs\{\{nl\}\}- SMT\{\{nl\}\}- STW\{\{nl\}\}- PIR\{\{nl\}\}- Muscle relaxers} \tn 
% Row Count 15 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
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\begin{tabularx}{17.67cm}{x{7.7715 cm} x{9.4985 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Capsulitis of the Hip}}  \tn
% Row 0
\SetRowColor{LightBackground}
• {\bf{Intro:}} & - Also known as: adhesive capsulitis \& 'frozen hip'\{\{nl\}\}- Non-specific \& painful ROM limitations \tn 
% Row Count 5 (+ 5)
% Row 1
\SetRowColor{white}
• {\bf{Aetiology (risk factors):}} & - May appear as 1° condition, develops w/o underlying cause\{\{nl\}\}- May occur as 2° entity, superimposed on underlying joint pathology\{\{nl\}\}- Commonly affects middle-aged females, suggesting potential hormonal or demographic influence\{\{nl\}\}- Unknown triggers: initiate inflammatory response leading to a frozen hip\{\{nl\}\}- Nocturnal or weight-bearing aggravation \tn 
% Row Count 22 (+ 17)
% Row 2
\SetRowColor{LightBackground}
• {\bf{Pathophysiology:}} & - Often begins w/ synovial membrane inflammation\{\{nl\}\}- Over time, inflammatory process may lead to fibrosis of the joint\{\{nl\}\}{\bf{Stages of frozen hip:}}\{\{nl\}\}{\bf{ 1 \& 2}} represent acute AC, where px is typically the 1° Ssx\{\{nl\}\}{\bf{3 \& 4}} represent chronic AC, characterised by ROM limitations as the 1° Ssx \tn 
% Row Count 36 (+ 14)
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{x{7.7715 cm} x{9.4985 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Capsulitis of the Hip (cont)}}  \tn
% Row 3
\SetRowColor{LightBackground}
• {\bf{Clinical presentation:}} & - Non-specific px\{\{nl\}\}- Nocturnal px or px exacerbated by weight bearing may occur\{\{nl\}\}- Progression of Ssx \tn 
% Row Count 5 (+ 5)
% Row 4
\SetRowColor{white}
• {\bf{Physical examination:}} & - ↓ ROM\{\{nl\}\}- Muscle weakness due to px \& stiffness: flexors, extensors, abductors, \& adductors\{\{nl\}\}- Potential instability or laxity of joints\{\{nl\}\}- Soft tissue palpation: potential tenderness, swelling, or warmth\{\{nl\}\}- Gait alterations or compensatory movements\{\{nl\}\}- Sensory \& motor function in LL (nerve or vascular compromise)\{\{nl\}\}{\bf{Special test:}}\{\{nl\}\}- Thomas test\{\{nl\}\}- Ober's test\{\{nl\}\}- FABER test\{\{nl\}\}- Provocative manoeuvres \tn 
% Row Count 26 (+ 21)
% Row 5
\SetRowColor{LightBackground}
• {\bf{Diagnosis:}} & - Challenging to Dx due to limited value in standard diagnostic tests \& imaging techniques\{\{nl\}\}- Differentiate from {\emph{Arthrofibrosis}}: AC is distinct from arthrofibrosis (knee, elbow, shoulder), \& the initial inflammatory phase in AC progresses to capsular fibrosis\{\{nl\}\} AC can lead to arthrofibrosis \tn 
% Row Count 40 (+ 14)
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{x{7.7715 cm} x{9.4985 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Capsulitis of the Hip (cont)}}  \tn
% Row 6
\SetRowColor{LightBackground}
• {\bf{Management:}} & - SMT\{\{nl\}\}- Pressure dilation\{\{nl\}\}- NSAIDs\{\{nl\}\}- Exercise program\{\{nl\}\}- Steroid injections\{\{nl\}\}- Surgery \tn 
% Row Count 5 (+ 5)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{\{\{popup="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4808257/"\}\}link text\{\{/popup\}\}}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{x{7.7715 cm} x{9.4985 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Congenital Dislocation of the Hip (CDH)}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{• {\bf{YELLOW}}} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
• {\bf{Intro:}} & - Also known as developmental dysplasia of the hip (DDH)\{\{nl\}\}- Caused by abnormal hip development \& can manifest in infancy or early childhood\{\{nl\}\}- Multifactorial cause, involving genetic, environmental, \& mechanical factors \tn 
% Row Count 12 (+ 11)
% Row 2
\SetRowColor{LightBackground}
• {\bf{Aetiology (risk factors):}} & - F\textgreater{}M (4:1)\{\{nl\}\}- Breech position in the last trimester (most significant risk)\{\{nl\}\}- Family Hx\{\{nl\}\}- swaddling in the adducted \& extended position\{\{nl\}\}- Postmaturity (prematurity isn't associated w/ ↑ risk)\{\{nl\}\}- 69.5 / 1000, but most are self-limiting in approx. 6-8. weeks\{\{nl\}\}- Leaving 4.8 / 1000, which need further treatment \tn 
% Row Count 28 (+ 16)
% Row 3
\SetRowColor{white}
• {\bf{Pathophysiology:}} & - Under-coverage of femoral head due to disrupted contact can lead to abnormal development\{\{nl\}\}- Swaddling in an extreme position hinders proper hip development\{\{nl\}\}- Acetabulum continues to grow up to age 5\{\{nl\}\}- Prolonged maligned contact causes chronic changes like capsule hypertrophy, ligament teres hypertrophy, \& thickened acetabular edge \tn 
% Row Count 44 (+ 16)
\end{tabularx}
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\begin{tabularx}{17.67cm}{x{7.7715 cm} x{9.4985 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Congenital Dislocation of the Hip (CDH) (cont)}}  \tn
% Row 4
\SetRowColor{LightBackground}
• {\bf{Clinical presentation:}} & - Mild hip instability\{\{nl\}\}- Limited ABD in infants\{\{nl\}\}- Asymmetric gait in toddlers\{\{nl\}\}- Hip px in adolescence\{\{nl\}\}- OA in adults \tn 
% Row Count 7 (+ 7)
% Row 5
\SetRowColor{white}
• {\bf{Physical examination:}} & - Trendelenburg gait (abductor insufficiency)\{\{nl\}\}- Lx lordosis\{\{nl\}\}- Leg length discrepancies \tn 
% Row Count 12 (+ 5)
% Row 6
\SetRowColor{LightBackground}
• {\bf{Diagnosis:}} & - US\{\{nl\}\}- X-ray \tn 
% Row Count 13 (+ 1)
% Row 7
\SetRowColor{white}
• {\bf{Complications:}} & {\bf{Failure to identify \& treat:}}\{\{nl\}\}- Functional disability\{\{nl\}\}- Hip px\{\{nl\}\}- Accelerated OA \tn 
% Row Count 18 (+ 5)
% Row 8
\SetRowColor{LightBackground}
• {\bf{Management:}} & - Pavlik harness\{\{nl\}\}- Adolescent / adult hip preservation surgery \tn 
% Row Count 22 (+ 4)
% Row 9
\SetRowColor{white}
• {\bf{Ddx:}} & - Proximal femoral focal deficiency\{\{nl\}\}- Femoral neck fracture\{\{nl\}\}- Coxa vara\{\{nl\}\}- Residual effects of infective arthritis \tn 
% Row Count 28 (+ 6)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{\{\{popup="https://www.ncbi.nlm.nih.gov/books/NBK563157/"\}\}link text\{\{/popup\}\}}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}



\end{document}