A 70-year-old female patient comes in for a follow-up visit for pain and stiffness in her left hip. She injured her hip in a skiing accident three years before and reports the X-rays at that time showed no fractures. Due to no obvious fracture at the time, she was given ibuprofen and advised to put ice on the affected area. She is now experiencing increased pain and stiffness in her right hip, usually in the morning, which has been happening for the past four weeks. She is taking over-the-counter non-steroidal anti-inflammatory drugs to relieve the pain. The patient does not show any weight loss or gain and has no complaint of fatigue.
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Explore This IssueNovember 2015
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The patient is a fit adult, with a generally good appearance. Her gait is normal. Her muscle strength is normal in her lower extremities. There is tenderness on palpation of the right hip. There is no swelling or crepitus. A single-view X-ray of the bilateral hips was done for a comparison. The right hip is normal, but the left hip shows sclerosis of the superior aspect of the acetabulum, including a single Egger cyst.
The patient is assessed with post-traumatic osteoarthritis of the right hip. Physical therapy is ordered three times a week for four weeks, and she is prescribed 300 mg ibuprofen twice a day. She is to return for follow-up in six weeks.