Atypical Presentation Of Weightlifter Hip Pain

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Atypical Presentation Of Weightlifter Hip Pain - Page #1

Author: Arthur Boyd, MD, ALM, EdM Co Author #1: Eleonora Demyda, MD Co Author #2: George Friedhoff, DO Senior Editor: Yaowen (Eliot) Hu, MD, MBA Patient Presentation: The patient is a 22-year-old male college student who presented with right hip pain and instability for 2 months after performing a hang clean lift. History: During the weight lifting episode, the patient felt sudden severe pain, clicking, and instability with his right hip giving out. There were associated symptoms of intermittent right hip weakness, pain with weight bearing, and sleep disturbance. The mechanism of injury was recalled to be hyper-abduction and extension of the hip followed by difficulty ambulating. The patient was unable to continue weight lifting and has continued to have right hip pain and instability for 2 months. The hip pain is relieved by lying supine. He has tried and failed the use of a chiropractor, physical therapy, and NSAIDs. He denies back pain, contralateral hip pain, or pain with coughing and sneezing. His family history was positive for HLA-B27. Physical Exam: General: Mild pain and in distress. Right Hip Exam: He had a positive single leg hop test and positive femoral acetabular impingement testing. He had short leg gait. He was positive for pain with contralateral straight leg raise. There was decreased right quadriceps and hamstring strength with decreased sensation to pinprick and light touch. Pulses were normal but there was tenderness and swelling noted at the right iliac crest. There was limited active range of motion compared to the left side but symmetric passive range of motion bilaterally. Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.		Back
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