Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with progressive, activity-related deep groin and proximal thigh pain. Symptoms are consistent with a high-risk lytic lesion in the proximal femur. No history of acute trauma; however, pain is exacerbated by weight-bearing. Patient reports localized tenderness and mechanical instability. History significant for [Primary Malignancy], currently under oncologic management.
Clinical Examination Findings
Physical exam reveals antalgic gait, requiring assistive device for ambulation. Palpation demonstrates focal tenderness over the greater trochanter and proximal femoral shaft. Range of motion of the hip is limited by pain, particularly with internal rotation and abduction. Neurovascular status is intact distally. No signs of acute fracture displacement or soft tissue compromise.
Treatment Protocol
Immediate recommendation for prophylactic stabilization of the proximal femur to prevent impending pathologic fracture. Plan includes orthopedic surgical consultation for intramedullary nailing or cephalomedullary fixation. Strict weight-bearing restrictions (non-weight bearing or toe-touch weight bearing) initiated pending surgical intervention. Pain management and oncology coordination for adjuvant radiation or systemic therapy.