Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with insidious onset of left-sided anterior hip and groin pain, exacerbated by hip flexion, prolonged sitting, and rising from a seated position. Reports occasional audible snapping or clicking sensation in the left groin. Denies trauma, radicular symptoms, or constitutional symptoms. Pain is localized to the iliopsoas musculotendinous unit.
Clinical Examination Findings
Left hip examination reveals tenderness to palpation over the iliopsoas tendon at the level of the femoral head. Positive resisted hip flexion test. Positive Thomas test and modified Thomas test reproducing anterior groin pain. No evidence of labral pathology or intra-articular hip joint effusion. Gait is antalgic, favoring the left lower extremity. Neurovascular status intact distally.
Treatment Protocol
Initiate conservative management including activity modification, avoidance of repetitive hip flexion, and non-steroidal anti-inflammatory drugs (NSAIDs). Prescribe targeted physical therapy focusing on iliopsoas stretching and core stabilization. Consider ultrasound-guided corticosteroid injection if symptoms persist despite 6 weeks of conservative therapy.