Patient with Referred Hip Pain



Fig. 44.1.
MRI of the pelvis, non-contrast, T2 axial view. Right anterior acetabulum with intermediate linear increased intensity signal, suggestive of labral tear (yellow arrow). Also, concomitant osseous bump at femoral head-neck junction suggestive of CAM-type femoroacetabular impingement (yellow asterisk). MR arthrogram is indicated.





Diagnosis


Right hip labral tear with FAI.


Treatment


The patient was referred to an orthopedic specialist for evaluation and treatment. MR arthrogram confirmed the diagnosis. He underwent joint injection, with resolution of his pain. He is scheduled for arthroscopic surgery.


Outcomes and Discussion


Hip disorders, especially labral tears, may present with groin pain. A detailed history and physical examination are key to help differentiate their diagnosis from other diagnoses, such as inguinal hernia. In fact, it is not uncommon for a patient to have an inguinal hernia at the same setting of a hip disorder. It is important to correctly diagnose the cause of the patient’s groin pain and to provide treatment focused on that disorder. In my practice, I often see patients who undergo elective inguinal hernia repair, with no improvement in their preoperative symptoms. Workup proves that their preoperative symptoms were indeed due to another pathology, such as a hip disorder, and their inguinal hernia was asymptomatic. A poor outcome would be to have a complication from the elective inguinal hernia repair while at the same time the patient’s main cause of preoperative pain was due to the hip disorder, thus altogether complicating the patient’s plan of care, outcome, and recovery.

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Oct 21, 2016 | Posted by in PAIN MEDICINE | Comments Off on Patient with Referred Hip Pain

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