🦴 Section 728.5 · Hip and Pelvis Injuries

Nelson Textbook of Pediatrics 22nd Edition | Apophyseal avulsion fractures: ASIS (sartorius), AIIS (rectus femoris), ischial tuberosity (hamstrings), iliac crest (abdominals), lesser trochanter (iliopsoas). Hip pointers: iliac crest contusion. Femoral neck stress fracture: tension side (superolateral) high risk of AVN. Snapping hip syndrome: external (IT band over greater trochanter) vs internal (iliopsoas over pectineal eminence). Osteitis pubis: pubic symphysis inflammation. Athletic pubalgia (sports hernia): groin pain, no true hernia. Femoroacetabular impingement (FAI): cam (femoral head-neck) or pincer (acetabular overcoverage).

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📋 30 Clinical Scenarios — Hip and Pelvis Injuries

📇 High‑Yield Review Cards

🩺 Clinical Recognition: Hip and Pelvis Injuries

Select a presentation to review diagnostic clues and management per Nelson 728.5.

📋 Stepwise Management of Hip and Pelvis Injuries

🔑 Key Principles — Nelson Section 728.5
• Apophyseal avulsion fractures: ASIS (sartorius), AIIS (rectus femoris), ischial tuberosity (hamstrings), iliac crest (abdominals), lesser trochanter (iliopsoas). Treatment: conservative (crutches, rest, ice) for most; surgery for displaced >2 cm.
• Femoral neck stress fracture: Tension side (superolateral) — high risk AVN, requires surgical fixation. Compression side (inferomedial) — conservative (non-weight-bearing).
• Snapping hip syndrome: External (IT band over greater trochanter) — Ober test. Internal (iliopsoas over pectineal eminence). Treatment: stretching, PT; surgery rarely.
• Athletic pubalgia (sports hernia): Groin pain, no true hernia. MRI or dynamic ultrasound. Surgery if conservative fails.
• FAI: Cam (femoral head-neck) or pincer (acetabular). MRI arthrogram. Surgery (arthroscopic osteoplasty) if conservative fails.

    ⚡ Reflex Prompts — Clinical Decisions

    📖 Summary: Hip and Pelvis Injuries (Nelson 728.5)