Author: Andrew Creighton, DO
Co Author #1: Devyani Hunt, MD
Co Author #2: Heidi Prather, DO
Co Author #3: John Clohisy, MD
Editor: Christopher Jordan, MD, ATC
A 20-year-old female, right-handed, collegiate golfer presented with one year of bilateral - right greater than left - hip pain.
The patient's bilateral hip pain had progressed over the course of the prior three months. Pain intensity was noted to be 3/10. The pain was "aching" in nature, improved with rest and worsened with activity, specifically walking a golf course. However, the patient reported no pain when swinging the golf club. Previous treatment included: nonsteroidal anti-inflammatories and tramadol. Her family history was significant for a brother who underwent arthroscopy and osteoplasty for symptomatic combined-type femoroacetabular impingement (FAI) and a father who had bilateral hip arthroplasties.
The patient walked with normal gait and physical exam was notable for the following bilateral positive provocative tests: 1) anterior impingement, 2) apprehension, 3) lateral impingement, 4) Flexion Abduction External Rotation, 5) pain over the psoas with palpation during resisted hip flexion. Passive hip internal rotation with the hip flexed at 90 degrees was 10 degrees bilaterally. Passive hip external rotation with the hip flexed 90 degrees was 50 degrees on the right and 60 degrees on the left.
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