An Uncommon Cause of Lateral Hip Pain After Multitrauma

AbstractBorderline hip dysplasia and acetabular retroversion are common radiographic findings in young individuals with and without hip pain. Orthopaedic surgeons should be knowledgeable about the radiographic findings, diagnosis, and appropriate nonsurgical and surgical treatment of these conditions. Borderline hip dysplasia is generally defined by a lateral center edge angle of Wiberg from 20 to 25° (some define as 18–25°) and is a cause of joint microinstability. The degree of soft tissue laxity can have significant implications for joint stability in patients with borderline hip dysplasia. The most common presenting symptoms are groin pain and lateral hip pain. Acetabular retroversion is defined by radiographic findings of crossover sign, ischial spine sign, and posterior wall sign. Individuals with symptomatic retroversion have a clinical presentation consistent with impingement, groin pain with flexion activities, and less commonly lateral hip pain. Physical therapy has been shown to improve symptoms in a subset of individuals with these conditions. There are multiple recent publications about arthroscopic treatment of patients with borderline hip dysplasia. These reports generally find that good short-term outcomes can be expected when using arthroscopic techniques that include labral preservation/repair and capsular plication. There are limited reports of periacetabular osteotomy as a treatment for borderline hip dysplasia. Publications focusing specifically on surgical treatment of acetabular retroversion are also infrequent. Periacetabular osteotomy has been shown to have superior long-term clinical outcomes to surgical hip dislocation with anterior rim trimming in patients with all three radiographic findings of retroversion. Arthroscopic treatment has been shown to have good short-term outcomes. Future work in the areas of borderline hip dysplasia and acetabular retroversion should focus on reporting long-term clinical follow-up of these surgical treatments and using computation techniques as a tool to determine appropriate surgical and nonsurgical treatment for each individual patient.

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Bi-Lateral Hip Pain - Basketball

Medicine & Science in Sports & Exercise ◽

10.1249/01.mss.0000477177.61209.00 ◽

2015 ◽

Vol 47 ◽

pp. 274-275

Author(s):

Shawn Felton ◽

Ireliam Guadalupe

Keyword(s):

Hip Pain ◽

Lateral Hip Pain

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Silicone-Induced Foreign Body Reaction: An Unusual Differential Diagnosis of Posterolateral Hip Pain

Case Reports in Medicine ◽

10.1155/2018/1802794 ◽

2018 ◽

Vol 2018 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Karishma Ramsubeik ◽

Omar Tolaymat ◽

Gurjit Kaeley

Keyword(s):

Differential Diagnosis ◽

Foreign Body Reaction ◽

Subcutaneous Fat ◽

Gluteus Maximus ◽

Hip Pain ◽

Soft Tissue Augmentation ◽

Resonance Imaging ◽

Silicone Injection ◽

Case Presentation ◽

Lateral Hip Pain

Background. Silicone injection is commonly used for soft tissue augmentation for esthetic purposes. It is not without complications. Case presentation. We present a case of a 31-year-old woman presenting with refractory left lateral hip pain. Magnetic resonance imaging of the patient’s pelvis revealed innumerable small low signal foci throughout the gluteus maximus and overlying subcutaneous fat bilaterally consistent with injectable material, possibly silicone. Conclusions. This case report emphasizes that silicone-induced granulomatosis must be considered in the differential diagnosis of hip pain when evaluating a patient who has had access to plastic surgery or clandestine operators.

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Intra-articular hip injections for lateral hip pain

Journal of Hip Preservation Surgery ◽

10.1093/jhps/hnu012 ◽

2014 ◽

Vol 1 (2) ◽

pp. 71-76 ◽

Cited By ~ 5

Author(s):

M. C. Bessette ◽

J. R. Olsen ◽

T. R. Mann ◽

B. D. Giordano

Keyword(s):

Hip Pain ◽

Lateral Hip Pain

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Pathogenesis and contemporary diagnoses for lateral hip pain: a scoping review

Knee Surgery Sports Traumatology Arthroscopy ◽

10.1007/s00167-020-06354-1 ◽

2020 ◽

Author(s):

Karadi Hari Sunil Kumar ◽

Jaikirty Rawal ◽

Naoki Nakano ◽

André Sarmento ◽

Vikas Khanduja

Keyword(s):

Scoping Review ◽

Pain Syndrome ◽

Gluteus Medius ◽

Hip Pain ◽

Greater Trochanteric Pain Syndrome ◽

Trochanteric Bursitis ◽

Snapping Hip ◽

External Snapping Hip ◽

Snapping Hip Syndrome ◽

Lateral Hip Pain

Abstract Purpose Recent advances in diagnostic imaging techniques and soft tissue endoscopy now allow for precise diagnosis and management of extra-articular hip pathology. The aim of this scoping review is to present an evidence-based update of the relevant literature focussing only on the pathoanatomy, clinical assessment and the diagnosis of pathology in the peritrochanteric space. Methods A literature search was performed on PubMed to include articles which reported on the anatomy and diagnosis of greater trochanteric pain syndrome, trochanteric bursitis, gluteus medius tears and external snapping hip syndrome. Results A total of 542 studies were identified, of which 49 articles were included for full text analysis for the scoping review. Peritrochanteric space pathology can be broadly classified into (1) greater trochanteric pain syndrome (GTPS), (2) abductor tears and (3) external snapping hip syndrome. Anatomically, gluteus medius, gluteus minimus and tensor fascia lata work in conjunction to abduct and internally rotate the hip. The anterolateral part of the gluteus medius tendon is more prone to tears due to a thin tendinous portion. Increased acetabular anteversion has also been shown to be associated with gluteal and trochanteric bursitis. In terms of clinical examination, tests which were found to be most useful for assisting in the diagnoses of lateral hip pain were the single-leg stance, resisted external derotation of the hip, hip lag sign and the Trendelenburg’s test. Dynamic ultrasound along with guided injections and MRI scan do assist in differentiating the pathology and confirming the diagnosis in patients presenting with lateral hip pain. Finally, the assessment of baseline psychological impairment is essential in this group of patients to ensure outcomes are optimised. Conclusion Lateral hip pain used to be a poorly defined entity, but advances in imaging and interest in sports medicine have led to a better understanding of the pathology, presentation and management of this cohort of patients. A thorough appreciation of the anatomy of the abductor musculature, specific clinical signs and imaging findings will lead to an appropriate diagnosis being made and management plan instituted. Level of evidence IV.

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