💡Case study brought by #traineeGP , second opinion by me
👀 52 M presented with groin pain left >right
Active and fit plays hockey, football, gym 3/week - free weights and machines
👀 PMH- NAD
👀 Pain and tenderness on pubic symphysis
🧐 Hip FROM , Resisted hip movements 5/5 not painful , lumbar spine clear , gait ,balance function - no deviations , slight pains with hip internal rotation and SCOUR ? Left > right
❓Differentials - #adductorstrain , #Hipflexor , #OA , #osteitispubis ( TraineeGp) and #avn
🩻 suggested GP to get X-ray
#avascularnecrosis femoral head - AVNFH
is rare 2 per 100000 in UK😵
💁♂️M 25-44 age
💁♀️F 55-75 age
⚠️Risk factors -
#alcoholism 🍺 , #smoking 🚬, #obesity ,
🧐Examination - hip rotation in supine or sitting
Referred to #orthopaedics for urgent MRI ‼️
⚠️early detection is necessary if needs surgery or treatment
👀One of the common causes for #hipreplacement
#primarycare #fcp #firstcontactphysiotherapy #firstcontactphysio #mdtworking #multiprofessional #primarycarenetwork
