Term
| A 23-year old black male presents with persistent pain in the left hip. The pain is unaffected by position or movement. On examination, there is mild jaundice. The spleen is moderately enlarged. There is a true short leg on the left side and the hip is held in slight internal rotation. A peripheral blood smear shows numerous sickle-shaped red blood cells. X-ray of the left hip shows a crescent sign. |
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| On routine examination of a 3-month-old infant, there is a click when the knees and hips are flexed and then the hips are abducted. The gluteal fold is higher on the left side. X-ray of the hip shows lateral displacement of the left femur and a small femoral epiphysis. |
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| A 29-year old female presents with a painful immobile right hip after being involved in a bus accident. On examination, there is a right short leg. There is decreased ROM in the right hip in all planes. X-ray of the right hip shows that the head of the right femur lies outside the acetabular fossa. |
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| A 23-year equestrian complains of pain in the left side of her bottom after she has been riding for a prolonged period. On examination, there is well-localized tenderness and swelling over the left ischial tuberosity. What is the diagnosis? |
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| A 6-year old boy presents with a painful limp. There is pain in his right hip and the pain radiates to the right knee. There is a history of a similar condition and he weighed only 3 lbs 14 oz at birth. On examination, there is limited abduction and internal rotation of the right hip. X-ray shows a smaller ossification center of the femoral epiphysis compared to the left side. |
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Definition
| Legg-Calvé-Perthes Disease |
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| An overweight 56-year old female presents with pain in the left hip that causes her to limp when she walks. The pain was initially only in the anterior hip but now has spread to the lateral region. On examination, there is decreased ROM especially on abduction and flexion. X-ray of the hip shows asymmetric joint space narrowing, subchondral sclerosis and osteophyte formation. |
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Definition
| Osteoarthritis of the hip |
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| An overweight 13-year old teen presents with a limp because of pain in the left hip. On examination, the left leg is externally rotated and there is decreased flexion, abduction and medial rotation of the left hip. X-ray of the hip in the frog-leg position shows downward slippage of the epiphysis of the head of the left femur. Kline’s line has been disrupted and the “ice cream falling off the cone” sign is present. |
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Definition
| Slipped Capital Femoral Epiphysis |
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| A 15-year old male basketball player presents with pain and a snapping sensation when he runs backwards during training. There is no previous history of trauma. On examination, there is a loud snapping sound when the hip is flexed and then extended. |
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| A 78-year old female presents with severe pain in her left hip. She slipped on the pavement and could not stand up. On examination, the left lower limb is short by 1 inch and is externally rotated. The anvil sign is positive. X-ray shows a break of the neck of the left femur just below the femoral head. |
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| Subcapital Femoral Fracture |
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| An 18-year old ballet dancer presents with pain in the lateral aspect of her right hip. The pain radiates down the lateral aspect of the thigh towards the knee. The pain is worse when she lies on the hip. On examination, there is point tenderness over the greater trochanter. Passive external rotation and hip adduction cause pain. Active abduction also reproduces the pain. |
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