Clinical Consult
I have been reading the book by Dr. Shirley
Sahrmann, entitled, "Diagnosis and Treatment of Movement Impairment Syndromes,"
and it appears there are at least two impairment-based classifications for the
patients with hip osteoarthritis (OA). Specifically, patients in
the "femoral accessory motion hypermobility" group (p166) have hypermobility of
accessory motions, and their medial/lateral hip rotation may be associated with
superior glide of the femur. In contrast, patients in the "femoral hypomobility
with superior glide" (page 168) group have markedly limited hip
range-of-motion, and these patients usually develop compensatory movements of
lumbar extension and rotation while walking because of restriction hip motion.
In addition, Dianne Lee describes, in "The Pelvic Girdle," that "overactivation
if the deep external rotators of the hip pulls the greater trochanter posteriorly and
forces the femoral head anteriorly" (page 102). On the basis of the
abovementioned description, I wonder if anyone in the EIM community has used
found these classifications to be useful when managing the patients with hip OA.
Specifically, I would like to know how confident clinicians are in detecting a
superior or anterior glide of the femoral head.
I would appreciate any comments. Many thanks and have a
good weekend :P
Yonghao
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