Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic, progressive left hip pain, localized to the groin and lateral hip, exacerbated by weight-bearing activities and prolonged standing. Reports morning stiffness lasting <30 minutes, relieved by rest. Denies trauma, fevers, or night pain. Symptoms significantly impact activities of daily living and ambulation.
Clinical Examination Findings
Gait: Antalgic, favoring the left lower extremity. Inspection: No erythema, edema, or deformity. Palpation: Tenderness to palpation over the left greater trochanter and groin. Range of Motion (ROM): Left hip shows restricted internal rotation and abduction compared to the right. Provocative testing: Positive FADIR (Flexion, Adduction, Internal Rotation) and FABER (Flexion, Abduction, External Rotation) tests, eliciting concordant pain. Neurovascular: Distal pulses intact, sensation intact to light touch in L2-L4 dermatomes.
Treatment Protocol
Initiate conservative management: 1. Activity modification (avoid high-impact activities). 2. Physical therapy for hip abductor strengthening and range of motion. 3. Pharmacotherapy: NSAIDs as needed for pain and inflammation. 4. Weight management counseling. 5. Consider intra-articular corticosteroid or hyaluronic acid injection if symptoms persist.