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Hip pain

  • Common ddx

    • bursitis (aggravated by lying on that side, greater trochanter tender to palpation)
    • herniated disk (positive straight leg raise)
    • osteoarthritis, transient synovitis in children
  • Serious ddx

    • hip fracture
    • hip disclocation
    • avascular necrosis (sickle cell)
    • septic arthritis (fever)
  • Labs

    • xray
    • CBC, chem
    • ESR, arthritis panel
    • INR if on anticoagulation
    • tuberculin test
    • bone scan if occult fracture
    • SPEP if MM
    • MRI if avascular necrosis
  • Pediatric ddx

    • transient synovitis
    • slipped femoral epiphysis (obese child)
    • legg-calve-perthes
    • rheumatic fever (fever, hx of strep infection)
  • HPI

    • onset, triggering events
    • quality, quantity
    • location: inner (joint), outer (bursa), posterior (sciatic nerve)
    • unilateral vs bilateral
    • aggravation, alleviation
    • radiation of pain
    • progression
  • ROS

    • fever
    • trauma, falls, syncope
    • back pain, leg pain, numbness, tingling
    • ability to bear weight
    • aggravation with position, such as lying on one side
    • PMH of sickle cell, coagulopathy
    • anticoagulation, warfarin
  • PMH

    • arthritis, osteoporosis, rheumatic fever, untreated strep throat
  • FH

  • SH

  • Meds

  • Allergies

  • Px

    • vitals
    • inspection: deformity, posture
    • palpation: tenderness
    • ROM
    • strength, reflex
    • straight leg test
    • distal pulses
    • gait

  • Print | Citations

    Disclaimer: MDHero Workups is for educational use only, and is not meant to replace the clinical judgement of a professional. We do not guarantee the accuracy of any information on this website.