TRIP

Hip Pointer (Diagnosis)

eMedicine.com, 2011

Considered Bursitis of the greater trochanter Avulsion fracture of the iliac apophysis Periostitis/myositis ossificans Soft tissue tumors Intra-abdominal injuries Muscle strain injury (eg, external oblique tear, sports hernia) Iliotibial band syndrome Osteoid sarcoma Pelvic or stress fracture In children, also consider slipped capital femoral epiphysis (if groin pain exceeds hip pain), avascular necrosis of the hip, Legg-Calvé-Perthes disease, and transient synovitis.
Workup Laboratory Studies Typically, laboratory studies are not useful in the diagnosis of hip pointers.
Imaging Studies Plain radiographs: Order radiographs if fracture or myositis ossificans is considered possible.
CT scans: Consider CT scans if the patient has continued pain or if his or her pain exceeds that expected from examination findings.
Bone scans: Order a bone scan to exclude a stress response or fracture if initial radiographic findings are normal and the symptoms do not resolve or improve.
Procedures If a significant hematoma is present, then aspiration can provide some pain relief and help prevent development of myositis ossificans or pressure and compression of local nerves (eg, lateral femoral cutaneous nerve).
Compartment pressures can be measured if a thigh or gluteal compartment syndrome is considered possible.
[ ] References Adkins SB 3rd, Figler RA. Hip pain in athletes.  Am Fam Physician . Apr 1 2000;61(7):2109-18.  .
Hubbard TJ, Denegar CR. Does cryotherapy improve outcomes with soft tissue injury?.  J Athl Train . 9 2004;39(3):278-279.  .  .
Ruane JJ, Rossi TA. When groin pain is more than "Just a strain": Navigating a broad differential.  Phys Sports Med . 1998;26(4).
[ ] Further Reading [ ] Keywords iliac crest contusion, hip bruise, hip trauma, hip injury, hip pain, groin injury, contact sports, football, hockey, soccer, skiing, volleyball, high school athletic injuries, anterior iliac crest region, greater trochanteric region, femur, sartorius, tensor fascia lata, obliques, rectus femoris muscle, range of motion, ROM, ROM exercises [ ] Contributor Information and Disclosures Author John M Martinez, MD,  Consulting Staff, Department of Primary Care Sports Medicine, Coastal Sports and Wellness Medical Group John M Martinez, MD is a member of the following medical societies: , , and