Hip Pain

For hip OA, a patient must have hip pain and two of the following (1) an ESR less than 20 mm/hour, (2) radiographic femoral or acetabular osteophytes, or (3) radiographic joint space narrowing. 

Retinal hemorrhage occurred in four women after they had received epidural methylprednisolone for chronic back and hip pain (SEDA-20, 373 77). Retinal and choroidal vascular occlusions are a serious and sometimes lasting complication of periocular and facial injections of glucocorticoids (SEDA-21, 416). 

In 15 men with osteonecrosis of the femoral head after short-term therapy the mean duration of therapy was 21 (range 7-39) days and the mean dose in milligram equivalents of prednisone was 850 (range 290-3300) mg (269). The time from administration of glucocorticoids to hip pain was 17 (range 6-33) months. A new case of bilateral avascular necrosis of the femoral heads after high-dose short-term dexamethasone therapy as an antiemetic in cancer chemotherapy has been reported (270). 

A 70-year-old woman has left knee and hip pain for over a year. You give the diagnosis of OA and want to begin treatment. She has mild renal insufficiency and a history of Gl bleeding. Which agent is the best choice for this patient ... 

The temporomandibular joint (jaw) can be affected, resulting in malocclusion and difficulty in chewing food. Inflammation of cartilage in the chest can lead to chest wall pain. Hip pain may occur as a result of destructive changes in the hip joint, soft-tissue inflammation (e.g., bursitis), or referred pain from nerve entrapment at the lumbar vertebrae. 

Summary A 15-year-old African-American female with recurrent bilateral thigh and hip pain, anemia, and symptoms and laboratory evidence of a urinary tract infection. 

Silver MD, Jokl P (1999) Endometriosis of the pelvis presenting as a hip pain. Clin Orthop 368 207-211... 

Fig. 35.8. An 11-year-old female with hip pain. With MDCT, a circumscribed osteolysis with surrounding sclerosis in the left epiphysis of the femur is detected. In combination with the age of the patient, this is a typical finding of a chondroblastoma (biopsy proven)...

Three significant tender points are associated with the hip joint (Fig. 98-1). One might also consider the piriformis tender point when treating hip pain. The piriformis tender point is most closely associated with sacral dysfunctions and was discussed in Chapter 62, but because of its attachment to the posterior lateral trochanter, it is often interpreted as hip pain. Often it is necessary to treat the body of the piriformis tender point to relieve the trochanteric point. 

A 70-year-old woman presented with multiple symptoms of back and hip pain for 3 weeks. Although relevant somatic dysfunctions were noted to explain the chief symptom, examination of the lower extremities demonstrated + 2 pilling edema. The patient stated that she had had swollen ankles for several years and was on diuretics and calcium channel-blocking medication for this and her hypertension. The edematous legs made it difficult for her to walk comfortably the distances to the stores in her immediate neighborhood. She denied any history of myocardial infarction or shortness of breath. Other than the chief symptom, hypertension, and peripheral edema, there were no other medical problems. 

Overuse tendinopathies of the hip affect mostly the tendon of the tensor fasciae latae (Bass and Connel 2002) and the rectus femoris tendon. Patients complain of localized anterior hip pain vdiich comes on after or, in more severe disease, during sport activities. This condition typically involves sprinters and is secondary to a forceful extension of the hip. Physical examination reveals tenderness over the anterior superior and anterior inferior iliac spines. Contraction of the muscle against resistance can increase the local pain. Clinically, the diagnosis of tensor fasciae... 

The snapping hip has been defined as hip pain accompanied by an audible or palpable clicking or snapping during joint motion or walking. This syndrome... 

Fedrizzi MS, Ronchezel MV, Hiliaro MO et al (1997) Ultrasonography in the early diagnosis of hip joint involvement in juvenile rheumatoid arthritis. J Rheumatol 24 1820-1825 Fink AM, Berman L, Edwards D et al (1995) The irritable hip immediate ultrasound guided aspiration and prevention of hospital admission. Arch Dis Child 72 110-113 Frick SL (2006) Evaluation of the child who has hip pain. 

---