History And Physical Examination

A thorough history is the most useful clinical tool to diagnose and treat hip disease. The clinician should inquire about the location, frequency, pattern, and radiation of symptoms. Clicking, locking, and other mechanical symptoms are common with labral injuries, whereas pain, stiffness, and decreased hip range of motion may suggest an inflammatory process. The clinician should establish which factors exacerbate or relieve the symptoms, and whether the complaints are of an acute or chronic nature. Intraarticular hip pain usually presents as groin discomfort and may radiate to the anterior thigh. Pain which emanates from the thigh or buttock with radiation to the knee or below can often be attributed to a neurogenic disorder [12,13].

A history of coagulopathy, collagen disorder, vascular or inflammatory disorder, any history of malignancy, alcohol abuse, steroid therapy, or use of nonsteroidal anti-inflammatory drugs may help to guide the clinician's evaluation. Patients with a history of developmental dysplasia of the hip or brace use as a child, may have an arthritic process resulting from dysplastic changes. A history of trauma and any subsequent treatment should also be sought. A history of sports participation often yields helpful information. Athletes competing at a higher level of sport have a greater propensity to develop both labral tears and chondral injuries. Any history of prior hip surgery should also be elicited [12,13].

The physical examination should be thorough. The position of the hip at rest should be noted, as it may indicate the underlying pathology. For example, a hip that is abducted, flexed, and externally rotated achieves the greatest capsular volume, suggesting an effusion or synovitis. The patient's gait should be noted. Examination of the lumbar spine including motor function, sensation, range of motion, reflexes, and straight-leg raises must be performed to rule out lumbar spine pathology as the cause of symptoms. Leg-length discrepancies should be assessed [12,13].

The hip examination begins with palpation of bony prominences about the hip and assessment of range of motion. Side-to-side differences should be noted as they may indicate areas of pathology. Clicking, catching, or other mechanical symptoms during the examination are common findings associated with the diagnosis of a labral tear. Although chondral injuries may be associated with mechanical symptoms, there is no specific examination maneuver to assess for them. The impingement test should be performed in the supine position.

Guarding and decreased range of motion is also evaluated in the prone and lateral decubitus positions.

Cure Tennis Elbow Without Surgery

Cure Tennis Elbow Without Surgery

Everything you wanted to know about. How To Cure Tennis Elbow. Are you an athlete who suffers from tennis elbow? Contrary to popular opinion, most people who suffer from tennis elbow do not even play tennis. They get this condition, which is a torn tendon in the elbow, from the strain of using the same motions with the arm, repeatedly. If you have tennis elbow, you understand how the pain can disrupt your day.

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