Let's Do The Hokey Pokey - You Put Your Left Hip In: Hip Pain In A Collegiate Tennis Player

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Let's Do The Hokey Pokey - You Put Your Left Hip In: Hip Pain In A Collegiate Tennis Player - Page #1

Author: Pooja Sharma, MD Co Author #1: 1. Neeru Jayanthi, MD Co Author #2: 2. Kenneth Mautner, MD Co Author #3: 3. Wesley Troyer, DO 4. Wesley J. Manz, MS 5. Timothy L. Arleo Senior Editor: Krystian Bigosinski, MD Editor: Emily Miller, MD Patient Presentation: 19 year old male collegiate tennis player with worsening left hip pain. History: A 19-year-old male collegiate tennis player with a past medical history notable for a L2 pars stress fracture presented over the summer with a 5-year history of left greater than right hip pain. He had previously been diagnosed with femoroacetabular impingement (FAI) and received multiple intra-articular PRP injections back home in Spain with significant relief. Over the season, he developed increasing groin pain with tennis and decreased range of motion despite 3-4 months of focused physical therapy. He underwent arthroscopic labral repair, acetabuloplasty, femoroplasty, and microfracture and was able to return to play 9.5 months post-operatively He presented to clinic following that season with complaints of increased pain and decreased ROM. Physical Exam: Constitutional: Appears stated age. Musculoskeletal: Left Hip: Gait: non-antalgic Palpation: Tenderness over left anterior hip. ROM: Flexion 95 degrees, Extension 5 degrees, IR 15 degrees, ER 45 degrees, Abduction 40 degrees, Adduction 5 degrees with pain with terminal ROM worst in Flexion/IR. Muscle Strength: Full throughout left lower extremity. Special Tests: Positive FADIR, Femoral Log Roll. Negative Modified Thomas, Ober, Resisted sit up, adductor squeeze, and single leg hop. Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.		Back
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