![]() ![]() Tenderness over the greater trochanter suggests trochanteric bursitis, which can coincide with intra-articular hip disorder mass suggests tumor Tenderness indicates that tissue is involved. Ultrasonography, CT, endoscopy, or laparoscopy as indicatedĪsymmetry suggests SI joint dysfunction or leg-length discrepancy, either of which can cause SI joint pain, pubic symphysis pain, or muscle strain Pelvic pathology (e.g., endometriosis, ovarian mass, colon cancer) Physical therapy, analgesics, surgical hip replacement or resurfacing if refractory Pain with hip rotation or Patrick (FABER) test, limited range of motion late in disease process Pain radiating to the groin, stiffness, age older than 40 years Tender muscle, pain with stretching and with resistance of the affected muscle Pain early in exercise, recent increase in exercise Limited lumbar motion normal hip examination sensory or motor abnormalities in lower extremities positive straight leg raise (possibly) Pain with walking or prolonged sitting possible numbness, tingling, or weakness in lower extremities Lumbar spine pathology (e.g., T12-L2 disk herniation, degenerative disease) Radiography, magnetic resonance arthrography Hip pain with log roll or Patrick (FABER) test Hip pain with exercise recent trauma or overuse Joint aspiration and irrigation, antibiotics Radiography, complete blood count, erythrocyte sedimentation rate, joint aspiration Severe pain with recent onset, difficulty moving the hip, recent surgery, intravenous drug use Hernia palpated in inguinal or femoral canal Radiography, CT (hip, pelvis, or lumbar spine, depending on suspected location) Soft tissue mass near hip (e.g., sarcoma), pelvic mass, lumbar radiculopathy (if lumbar tumor) Physical therapy, corticosteroid injection arthroscopic debridement if refractoryįever, night sweats, night pain, weight loss, history of cancer Usually none MRI or ultrasonography can confirm ![]() Tender bursa over greater trochanter or iliopsoas tendon may accompany intra-articular hip pathology Hip pain with exercise or direct pressure Surgery or close observation by an orthopedic surgeon Pain with insidious onset that is worse with weight bearing recent trauma or corticosteroid use Whether arthroscopic treatment prevents or delays osteoarthritis of the hip is unknown. An important goal of arthroscopy is preservation of the hip joint. Treatment often requires arthroscopy, which typically allows patients to resume premorbid physical activities. Radiography, magnetic resonance arthrography, and injection of local anesthetic into the hip joint confirm the diagnosis. The use of flexion, adduction, and internal rotation of the supine hip typically reproduces the pain. Common aggravating activities include prolonged sitting, leaning forward, getting in or out of a car, and pivoting in sports. Patients with hip impingement often report anterolateral hip pain. ![]() It injures the labrum and articular cartilage, and can lead to osteoarthritis of the hip if left untreated. Hip impingement is increasingly recognized as a common etiology of hip pain in athletes, adolescents, and adults. ![]() Femoroacetabular impingement, also known as hip impingement, is the abutment of the acetabular rim and the proximal femur. ![]()
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