Author: Aaron Wolkoff, DO
Editor: Velyn Wu, MD
A 41-year-old female with a past medical history of hypertension presented with a 1 month history of left hip/upper thigh pain.
As she was getting out of the passenger side of her vehicle she fell and caught her left leg inside the car. She felt a tearing sensation to the anterior portion of her left groin. The pain was deep inside of her groin and did not radiate. She also felt that her thigh was tight like having “a flexed thigh.” She denied any radicular symptoms in her leg, bowel or bladder insufficiency, and back pain.
General: well appearing, in no acute distress with normal vital signs and pulses.
Skin: warm and dry.
Neurologic: normal sensation and strength to her lower extremity. Musculoskeletal:
Gait - antalgic with a shortened stance phase.
Lumbar exam - was normal,lumbar spine was non-painful on palpation. Pelvic alignment was forward flexed pelvis with an inflare.
Hip exam - showed logroll was painful out of proportion, Stinchfield test was painful, FABER/FADIR decreased range of motion and very painful, SCOUR exam was positive for pain to the groin. Thomas test positive. Very palpable iliopsoas pain.
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