July 2022 Journal Club

[David Brown]

Hey all,

Below is the case that I will be discussing this Thursday, let me know if you have any questions and I will see you all then!

(IE 6/14/22)

Subjective: Pt is a 6/2 y/o female who is a RN for UVA and began to experience mild lateral hip pain over the R greater trochanter around 1 year ago when commuting to and from work (~1 mile). Denies any MOI in connection to the onset of her sx. States that this was manageable and did not interfere with her daily life. States that this pain slowly disappeared around 6 months ago and did not come back until April of 2022 when she began a new “Jazzercise” class 4-5x/week that involved a lot of repetitive hopping- an activity she was not accustomed to.. Endorses a gradual onset of the same R hip pain that she had expercined for circa 6 months last year, but this time in a much more intense fashion that had begun to interfere with her everyday life. Reports that during her jazzercise class and for the remainder of the day afterwards her lateral hip pain increases and would even refer to the level of the knee. Describes the pain as an ache. States that her walking commute reproduces this pain currently, as does prolonged sitting. Describes the Denies any loss of sensation, back pain, or recent trauma to the back or R hip. She also denies any groin pain in conjunction with the hip pain

Aggs: Stairs (equal pain ascending and descending), walking, jazzercise class, prolonged sitting
Eases: Self pelvic tilts, gluteal stretching (temporary relief), warming up the involved tissues, cessation of aggravating activity

Observation: Sitting with R leg crossed over left; walks with a compensated trendelenburg gait

Objective:
Lumbar screen (-) for contributing pain to the R hip
Intra-articular hip screen R side (-) for contributing pain to the R hip (SCOUR, ASLR, FABER, FADDIR)
Weight shift to the left with Bil squat- did not attempt SL squat d/t pain
Decreased weight shift with hand held assist
Pain with stair step up, no pain with step down
Increased pain and contralateral hip drop with 30” SLS (could only tolerate ~20”)
Reproduction of pain with both resisted ER and IR (IR was more painful)
Reproduction of pain with palpation of GT only with little to no tenderness over muscle belly of glute med/min
Increased lateral hip pain with end range IR, and hip flexion/adduction quadrant
Joint mobility and PROM WNL other than end range IR which was limited to 35 degrees secondary to onset of lateral hip pain

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