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• W2806007905 abstract "HISTORY: A 17 year-old male who was a first year participant in shot put and discus events presented with gradual onset aching left hip pain for 3 weeks. He denied any precipitating trauma or injury prior to symptom onset. His pain localized primarily to the left proximal anterior thigh. Hip flexion and abduction aggravated the pain. He tried intermittent ice without improvement. He denied radicular pain, weakness, sensory, or mechanical hip symptoms. After 1 physical therapy session, the pain progressed to a 10/10 intensity, constant throbbing, sharp pain in the proximal anterior thigh. PHYSICAL EXAMINATION: Antalgic gait with shortened stance phase on the left. Focal tenderness to palpation at the AIIS and proximal hip flexor tendons. Range of motion was full and symmetric. Pain was elicited at the extremes of left hip flexion, internal rotation, and external rotation. No weakness with manual muscle testing, but he had pain with resisted hip flexion. Stinchfield elicited hip flexor and AIIS pain. FABER and FADIR aggravated left anterior hip pain. DIFFERENTIAL DIAGNOSIS: 1. Proximal Left Hip Flexor Muscle Strain 2. Traction Apophysitis 3. Labral Tear or other intra-articular hip pathology 4. Femur Stress Fracture 5. Abscess/infection TESTS AND RESULTS: Left Hip X-ray - Negative left hip. Left Hip MRI - Partial thickness tearing of direct/indirect heads of rectus femoris tendons with extensive surrounding edema. Between the direct/indirect heads, lateral to AIIS, a 2 cm x 1.5 cm oval mass-like lesion heterogeneously dark and bright on T2 and intermediate to minimally dark on T1 with suggestion of a rim of decreased T1/T2 signal. Minimal periosteal reaction with bone marrow edema. Normal articular cartilage. FINAL/WORKING DIAGNOSIS: Myositis Ossificans TREATMENT AND OUTCOMES: 1. Crutches given with instructions to weight bear as tolerated. 2. Naproxen BID started after MRI findings. 3. Continued therapy with only range of motion initially. 4. Instructed to avoid impact exercises/activities. 5. Repeat left hip x-ray six weeks later revealed calcification in soft tissues lateral to left hip consistent with heterotopic ossification. 6. Therapy program was advanced. Eight weeks later reported no symptoms during over 85% of activity. 7. Returned to football in the fall and completed outstanding season, no hip region pain." @default.
• W2806007905 created "2018-06-13" @default.
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• W2806007905 date "2018-05-01" @default.
• W2806007905 modified "2023-09-26" @default.
• W2806007905 title "Anterior Thigh Pain - Shot put/Discus" @default.
• W2806007905 doi "https://doi.org/10.1249/01.mss.0000536407.49768.38" @default.
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