Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic, progressive bilateral hip pain, worse with weight-bearing and prolonged activity. Pain is localized to the groin and lateral hip, occasionally radiating to the anterior thigh or knee. Reports morning stiffness lasting <30 minutes, relieved by rest. Patient notes functional limitations in gait, stair climbing, and activities of daily living. Previous conservative management includes NSAIDs and physical therapy with partial relief.
Clinical Examination Findings
Bilateral hip examination reveals antalgic gait. Range of motion (ROM) is restricted in both hips, particularly internal rotation and abduction, with associated crepitus on passive movement. Tenderness noted over the greater trochanteric bursa and groin. FABER and FADIR tests are positive, eliciting concordant pain. No signs of neurovascular compromise in the lower extremities.
Treatment Protocol
Initiate multimodal conservative therapy: weight management, low-impact aerobic exercise (swimming/cycling), and physical therapy for strengthening abductor and core musculature. Prescribe scheduled NSAIDs (if not contraindicated) or topical analgesics. Consider intra-articular corticosteroid or viscosupplementation injections for symptomatic relief. Discuss surgical consultation for total hip arthroplasty (THA) if conservative measures fail to improve quality of life.