Page 21 - Delaware Medical Journal - November/December 2020

CASE REPORT
Figure 2 MRI of the left hip, T2 sequence, showing hyperintense signal within the left femoral neck.
Figure 1 AP pelvis
CASE REPORT
A 40-year-old female initially presented to her primary care physician with a six-month complaint of left
hip pain. She had no significant past medical history or past surgical
history and no reported medications
or supplement use. Her BMI was 37 (weight 253lb, height 69 inches) and she was a non-smoker with no history of alcohol or drug use. She was employed at the time as an executive assistant doing primarily office-based work, which did not include any strenuous labor. She had a history of three normal childbirths without incident (two
girls, one boy). She also had a history of normal menstrual cycles without reported irregularity/abnormality.
Her pain began six months prior, without incident or trauma. The pain
was located in the groin, without radiation. She denied any significant low back pain. It progressively worsened with normal physical activity and was worse with weight-bearing than at rest. She was seen by her primary care provider for the pain
and was sent for physical therapy.
She completed six weeks of therapy without relief and rescheduled follow- up with her primary care provider. She had x-rays taken at that appointment which showed no obvious abnormality. She was given a prescription for further physical therapy, but did not follow through. She was prescribed short-acting oral steroids by her spine physician without significant benefit. She was also seen by a chiropractor without significant relief.
Her continued pain for an additional four months prompted an evaluation
Figure 3
MRI of the sacrum, T2 sequence, showing hyperintense signal
along the right hemisacrum.
at the orthopedic practice where the authors of this paper are employed. The physical exam showed intact range of motion, with pain along the anterior-lateral left hip. The patient’s main complaint continued to be left hip pain, primarily in the groin. New AP and lateral x-rays of the left hip showed good joint space preservation without any obvious signs of fracture or malignancy (Figure 1). Due to
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