TRIP

Hip Pointer (Overview)

eMedicine.com, 2011

Introduction Background A hip pointer is a contusion to the iliac crest, the surrounding soft tissue structures, or the greater trochanter of the femur.
Hip pointer injuries occur most commonly in contact sports (eg, football, hockey), but they can also occur in noncontact sports (eg, volleyball) as a result of a fall onto the hip or side.
Frequency United States No specific statistics for frequency of hip pointer injuries are available; however, hip injuries generally comprise 5-9% of high school athletic injuries.
Functional Anatomy The anterior iliac crest region of the hip and the greater trochanter of the femur have a minimal amount of overlying fatty tissue or muscle and are more susceptible to contusion and injury than more protected regions of the body.
The iliac crest has multiple muscle origins and insertions, including the sartorius, the tensor fascia lata, the internal and external obliques, and a portion of the rectus femoris muscle.
Clinical History Obtain a detailed history, including the mechanism of injury and the patient's description of his or her symptoms.
A hip pointer is usually an acute injury, and the patient can typically recall a precipitating event, though some may present 24-48 hours after the initial injury.
Hip pointer injuries are usually caused by a direct blow to the iliac crest or greater trochanter in contact sports such as football or hockey.
Typically, the patient presents with the sudden onset of hip pain in the iliac crest or greater trochanteric region after sustaining trauma.
The pain is localized and may be exacerbated with activities such as running, jumping, twisting, or bending.
The pain can limit range of motion (ROM) at the hip joint and/or rotation of the trunk if the abdominal musculature is involved.