SEACSM Clinical Conference Hip Pain while Playing Hoops

Vanderbilt Sports Medicine

SEACSM Clinical ConferenceHip Pain while Playing Hoops

Doug Connor, MDPediatric Sports Medicine Fellow

Vanderbilt University Medical CenterFebruary 2012


History13 year old male with right hip pain• Sudden onset 5 days prior while playing basketball• Jumped over another player and landed awkwardly• No pop, but immediately painful with painful limp

• Rested for 2 days and able to walk without pain• Tried to run and had severe sharp pain antero-

lateral right hip

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No significant PMHxDenies prescribed or OTC medicationsNo history of hip painNo history of previous fractureNo family history of metabolic or bone disorders

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Physical Exam• No acute distress• Stands with right lower extremity in slight external rotation,

antalgic gait with shortened stance on right• No tenderness along ASIS, AIIS, greater troch and pubis• Range of motion– Active ROM limited in all planes due to pain– Passive internal rotation of 20 degrees with sharp pain

• 4/5 strength hip flexion and abduction, both painful• Unable to FABER secondary to pain

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Questions?

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Differential Diagnosis• Apophyseal avulsion• Slipped Capital Femoral Epiphysis• Chondral lesion or Labral Tear• Adductor/Hip Flexion strain• Pelvic or Femoral Fracture• Snapping Hip• Avascular Necrosis04/20/23 Footer


Imaging

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Pelvis AP

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Examination Under Anesthesia• Underwent examination under anesthesia to

assess joint stability

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Diagnosis• Posterior Wall Acetabular Fracture– Unstable during EUA

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Outcome• Post-operatively did well• No complications related to surgery• Able to return to sport the following year

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Questions or Comments

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Thank You

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Documents

SEACSM Clinical Conference Hip Pain while Playing Hoops