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Dr. SH
Dr. SH, Board Certified Physician
Category: Medical
Satisfied Customers: 8796
Experience:  Doctor of Medicine
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My daughter aged 18 has acute hip pain. Usually it is unilateral

Resolved Question:

Hi, My daughter aged 18 has acute hip pain. Usually it is unilateral but today is bilateral. She is almost unable to weight-bear. She had a rigor last week in the morning but this resolved in 24 hours and seems unrelated. She is quite well in herself. She saw an orthopaedic surgeon last year but examination and straight ex-ray were negative and it was put down to an ilio-tibial band.
She's worst in the morning and on examination, she has pain on flexion and external rotation, other movements are full, free and painless.
My next step I think is to suggest she see a Rheumatologist. Just wondered if you have any ideas?
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. SH replied 2 years ago.
Hi there.
Thank you for your question.
I will be helping you out with your concerns today.
I am sorry to hear about your daughter.
Acute hip pain must always be evaluated further to rule out arthritis.
Therefore I would recommend seeing an orthopedic doctor or a rheumatologist.
Meanwhile she can continue using diclofenac.
If the x-rays turn out to be negative the next best test to do is MRI of the joint which will give a much clearer picture.
Let me know if you have more questions.
Kind regards
Customer: replied 2 years ago.

Hi,

She's seen an orthopaedic surgeon but he found very little. He concluded this was a an ilio-tibial band.

Although worse in the morning, she doesn't have pain in all directions of movement, making it unlikley to be arthritis (by definition). There is no clinically obvious redness or swelling or tenderness. If she externally rotates the hip (sits cross-legged) the joint is comfortable. Flexion and internal rotation cause pain. I presume this means that when the joint capsule is relaxed it is better.

X-rays taken last year, were normal. I'm puzzled because her symptoms seem to be deteriorating. Guess an MRI scan may shed further light and I'll ask her orthopaedic surgeon to see her again. My main purpose in asking was if there was anything obvious I'm missing.

Best to you,

Fred

Expert:  Dr. SH replied 2 years ago.
No you are not missing anything.
I agree in that it seems unlikely to be arthritis but again the MRI would be the test that would give us the answer most likely which is what I would recommend.
It does not sound like anything serious though.
Meanwhile I would recommend continuing to take anti-inflammatory medications like ibuprofen or diclofenac.
Let me know if you have more questions.
Please rate me by clicking on one of the rating options.
Kind regards
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