10 Years Of Bilateral Hip Pain In A Young Adult Male

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10 Years Of Bilateral Hip Pain In A Young Adult Male - Page #3

Lab Studies: Initial evaluation found severely low vitamin D (25-OH) and phosphate levels. Calcium was within normal limits. His parathyroid hormone and alkaline phosphatase were found to be elevated. Serial testing revealed persistently low phosphate and vitamin D (25-OH) despite repletion. Laboratory results are demonstrated below Case Photo #4 . Other Studies: Bilateral hip and pelvis x-rays demonstrated cortical thickening with compression-sided linear lucencies in the bilateral femoral necks compatible with chronic stress fractures. This was unchanged from prior imaging in 2015. Case Photo #1 Lumbosacral spine x-rays were negative. A pelvis MRI without contrast was consistent with prior x-rays, demonstrating chronic incomplete fractures spanning less than 50% of the femoral neck. It also revealed mild coxa vara bilaterally. Case Photo #2 Subsequent x-rays at 10 months and one year after the most recent ED presentation demonstrated no significant interval healing. Imaging showed neck-shaft angles with less than 120 degrees, being diagnostic for coxa vara. Case Photo #3 Consultations: At his most recent presentation to the ED, orthopedic surgery was consulted and no surgical intervention was recommended. Click here to continue. Challenge yourself by writing down a revised, working diagnosis before moving to the next slide.		Back
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