Swing From The Hip: An Unusual Cause Of Recurrent Hip Pain In A High School Softball Player

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Swing From The Hip: An Unusual Cause Of Recurrent Hip Pain In A High School Softball Player - Page #3

Other Studies: X-rays were initially obtained for hip pain to rule down the possibility of a stress fracture. X-rays were unremarkable. As her hip pain became recalcitrant despite physical therapy and rest from softball, magnetic resonance imaging (MRI) was ordered of her hip. Hip MRI discovered a large, heterogeneous dumbbell-shaped mass identified at the myotendinous junction of the iliopsoas muscle. Large hematoma associated with grade 2 iliopsoas tear identified. Iliopsoas tendon found to be intact. Case Photo #1 Case Photo #2 Despite further physical therapy, ibuprofen, and cyclobenzaprine, the pain persisted at one-month follow-up. Further MRI was obtained which demonstrated slight enlargement of hematoma. Complete blood count and coagulation studies were ordered. Complete blood count and coagulation studies were unremarkable. Consultations: Orthopedic oncology was consulted for evaluation of hematoma versus potential mass. Interventional radiology was then consulted for drain placement of hematoma along with tissue plasminogen activator (tPA). Patient became syncopal, requiring transfusion of packed red blood cells. Additional angiography identified left medial profundal femoris artery pseudoaneurysm. Case Photo #3 Click here to continue. Challenge yourself by writing down a revised, working diagnosis before moving to the next slide.		Back
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