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. @Medscape Case Challenge:
56 yo F no PMH presents w/ L hip pain ~4 mo. Worse w/ walking. Resolved w/ rest. Minimal improvement w/ PT/chiro. Became progressively worse especially at rest. NRS: 8/10 described as achy, localized in L hip. No radicular sxs, hip stiffness. Diagnosis?
56 yo F no PMH presents w/ L hip pain ~4 mo. Worse w/ walking. Resolved w/ rest. Minimal improvement w/ PT/chiro. Became progressively worse especially at rest. NRS: 8/10 described as achy, localized in L hip. No radicular sxs, hip stiffness. Diagnosis?
Over-the-counter pain relievers temporarily reduces pain to 5/10 on NRS. No past hx hip pain. Denies weakness, N/T In legs. No recent trauma. No fever, chills, blurry vision, double vision, cough, chest pain, shortness of breath, nausea, vomiting, or abdominal pain.
Patient is otherwise healthy and does not take any other medications beyond the aforementioned pain relievers. Denies smoking/alcohol. Postmenopausal. Family hx for a maternal aunt w/ breast cancer at age 45 years who underwent surgery, chemotherapy, and radiation treatment.
Exam findings:
Vital signs: BP 140/90 mm Hg, HR 85 beats/min, Temp 98.3°F, RR 15 breaths/min, weight 189 lb. Mental status: normal. Alert, oriented, no acute distress.
Normal muscle bulk, tone, upper-/lower-extremity strength. No swelling or deformities.
Vital signs: BP 140/90 mm Hg, HR 85 beats/min, Temp 98.3°F, RR 15 breaths/min, weight 189 lb. Mental status: normal. Alert, oriented, no acute distress.
Normal muscle bulk, tone, upper-/lower-extremity strength. No swelling or deformities.
No pain with compression of R/L hip. Normal sensation B. 5/5 strength hip flexion/extension, knee flexion/extension, ankle dorsiflexion/plantarflexion B. SLR (-). Normal gait.
CBC w/ differential, comprehensive metabolic panel WNL. https://reference.medscape.com/viewarticle/927985
CBC w/ differential, comprehensive metabolic panel WNL. https://reference.medscape.com/viewarticle/927985
