Hip

Question 1

An 18-year-old ballet dancer presents with pain in the lateral aspect of her right hip. The pain radiates down the lateral aspect of the thigh towards the knee. The pain is worse when she lies on the hip. On examination, there is point tenderness over the greater trochanter. Passive external and hip adduction cause pain. Active abduction also reproduces pain. Hip X-rays were normal.

Answer 1

Trochanteric bursitis

Question 2

A 6-year-old boy presents with a painful limp. There is pain in his right hip and the pain radiates to the right knee. There is a history of a similar condition and he weighed only 3 lbs 14 oz at birth. On examination, there is limited abduction and internal rotation of the right hip. X-rays showed a smaller ossification center of the femoral epiphysis compared to the left side.

Answer 2

Legg-Calve-Perthes disease

Question 3

A 23-year-old equestrian complains of pain in the left side of her bottom after she has been riding for a prolonged period. On examination, there is well-localized tenderness and swelling over the left ischial tuberosity. No tests were done.

Answer 3

Ischial bursitis

Question 4

An overweight 56-year-old female presents with pain in the left hip that causes her to limp when she walks. The pain was initially only in the anterior hip, but now it has spread to the lateral region. On examination, there is decreased ROM, especially on abduction and flexion. X-ray of the hip shows asymmetric joint space narrowing, subchondral sclerosis and osteophyte formation.

Answer 4

OA of the hip

Question 5

An overweight 13-year-old teenager presents with a limp because of pain in the left hip. On examination, the left leg is externally rotated and there is decreased flexion, abduction and medial rotation the hip. X-ray shows downward fall of epiphysis of the left femur head. Klein’s line has been disrupted.

Answer 5

SCFE

Question 6

A 23-year-old African male presents with persistent pain in the left hip. The pain is unaffected by position or movement. On examination, there is mild jaundice. The spleen is moderately enlarged. There is a true short leg on the left side and the hip is held in slight internal rotation. X-ray reveals crescent sign.

Answer 6

AVN of the hip (also SCA associated; need CBC to confirm)

Question 7

A 10-year-old boy complains of pain in his left hip. He had an upper respiratory tract infection recently. On examination, the left hip is slightly flexed, partially abducted and the limb is externally rotated. Internal rotation of the hip is decreased as well. X-ray was normal.

Answer 7

Transient Hip Synovitis

Question 8

A 49-year-old runner complains of pain in the left hip after running a race. He had injured the same hip a month ago. On examination, he has pain when asked to abduct the hip against resistance. Deep pressure above the hip joint laterally causes pain. X-ray shows localized area of irregular soft tissue calcification in the region of one of the hip abductors.

Answer 8

Gluteus medius muscle dysfunction