Hip Pain In A Collegiate Cross Country Athlete - Page #1

Author: Ryan Sprouse, MD
Co Author #1: Ryan A. Sprouse, MD
Co Author #2: Joseph H. Armen, DO
Co Author #3: Philip S. Perdue, Jr., MD

Patient Presentation:
A 22 year old Caucasian female Division I cross country athlete presented to clinic for an evaluation of hip pain.

During the six weeks prior to presentation, she gradually developed right hip and groin pain. The pain radiated to her right sacroiliac region, was sharp and intermittent, and associated with activity. The pain was present with running, other impact activities, and activities of daily living including walking. She denied traumatic injury. The athlete often ran greater than fifty miles weekly. Over the three weeks before presentation, she ceased running and was performing cross training and low impact activity that became pain free. She had taken NSAIDs for pain relief which helped slightly. She denied clicking, catching, or locking of her right hip joint. She denied bowel or bladder dysfunction, lower extremity neurologic symptoms, low back pain, or genitourinary symptoms. She had a history of stress fractures of the right third metatarsal and right fibula, irregular menses, and vitamin D deficiency. Her family and social histories were unremarkable.

Physical Exam:
Vitals: weight 116 pounds, height 61 inches, BMI 21.2, blood pressure 113/68, heart rate 77.
General: Healthy appearing Caucasian female.
Musculoskeletal: Normal walking gait. Right hip with normal range of motion and strength. Leg length equal. Groin pain with resisted hip adduction and anterior hip pain with resisted hip flexion. No tenderness to palpation of the pubic symphysis, hip adductors, or hip flexors. Tenderness to palpation over the right sacroiliac joint. FABER and FADIR caused a mild, poorly localized hip girdle pain. Log roll negative. Lumbar spine exam unremarkable.
Neurologic: Normal lower extremity exam.

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