Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic left hip pain, localized primarily to the groin, exacerbated by prolonged sitting, deep flexion, and internal rotation. Reports mechanical symptoms including catching, clicking, and occasional locking. Pain is described as a dull ache with sharp, stabbing episodes during athletic activity or sudden pivoting. No history of acute trauma. Symptoms have failed to improve with conservative management including activity modification and NSAIDs.
Clinical Examination Findings
Left hip examination reveals restricted range of motion, specifically in internal rotation and flexion. Positive FADIR test (Flexion, Adduction, Internal Rotation) reproducing characteristic groin pain. FABER test (Flexion, Abduction, External Rotation) may be positive or limited. Gait analysis demonstrates a non-antalgic gait, though patient exhibits guarding during provocative maneuvers. Neurovascular status intact distally. No significant tenderness to palpation over the greater trochanter.
Treatment Protocol
Initiate physical therapy focusing on hip abductor/core strengthening and pelvic stabilization. Activity modification to avoid end-range flexion and pivoting. Prescription of NSAIDs for inflammation control. Consider intra-articular corticosteroid injection for diagnostic/therapeutic purposes. If symptoms persist, discuss surgical options including hip arthroscopy for cam osteochondroplasty and labral repair.