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SEACSM Clinical Conference Hip Pain while Playing Hoops

SEACSM Clinical Conference Hip Pain while Playing Hoops. Doug Connor, MD Pediatric Sports Medicine Fellow Vanderbilt University Medical Center February 2012. History 13 year old male with right hip pain Sudden onset 5 days prior while playing basketball

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SEACSM Clinical Conference Hip Pain while Playing Hoops

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  1. SEACSM Clinical ConferenceHip Pain while Playing Hoops Doug Connor, MD Pediatric Sports Medicine Fellow Vanderbilt University Medical Center February 2012

  2. History 13 year old male with right hip pain • Sudden onset 5 days prior while playing basketball • Jumped over another player and landed awkwardly • No pop, but immediately painful with painful limp • Rested for 2 days and able to walk without pain • Tried to run and had severe sharp pain antero-lateral right hip Footer

  3. No significant PMHx Denies prescribed or OTC medications No history of hip pain No history of previous fracture No family history of metabolic or bone disorders Footer

  4. Physical Exam • No acute distress • Stands with right lower extremity in slight external rotation, antalgic gait with shortened stance on right • No tenderness along ASIS, AIIS, greater troch and pubis • Range of motion • Active ROM limited in all planes due to pain • Passive internal rotation of 20 degrees with sharp pain • 4/5 strength hip flexion and abduction, both painful • Unable to FABER secondary to pain Footer

  5. Questions? Footer

  6. Differential Diagnosis • Apophyseal avulsion • Slipped Capital Femoral Epiphysis • Chondral lesion or Labral Tear • Adductor/Hip Flexion strain • Pelvic or Femoral Fracture • Snapping Hip • Avascular Necrosis Footer

  7. Imaging Footer

  8. Pelvis AP Footer

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  12. Examination Under Anesthesia • Underwent examination under anesthesia to assess joint stability Footer

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  14. Diagnosis • Posterior Wall Acetabular Fracture • Unstable during EUA Footer

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  17. Outcome • Post-operatively did well • No complications related to surgery • Able to return to sport the following year Footer

  18. Questions or Comments Footer

  19. Thank You Footer

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