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Brandon Cohen DC, CSCS November 15, 2017 at 3:17 pm.
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Brandon Cohen DC, CSCS
15 year old female
Location: R. anterior hip pain and pain medial to the asis (separate and distinct locations)
Quality: soreness/pinching
Intensity: 7/10
Provocative: worse with hard running efforts. Once aggravated hip flexion is painful, and getting into and out of car, walking upstairs
Palliative: rest.
Patient initially presented with bilateral hip pain, worse on the right. Left hip pain as resolved and right continues to be a problem
Current exam: SLR: 90 degrees bilaterally with posterior thigh tension. SHF: 3 fingers to the ribs on the right with anterior hip pinching. (previously had range to 1 finger, and currently inflammation is blocking the motion.) QLF: flat from 0-2″ KHE: 12″ bilaterally with anterior hip pain when performed on the right.
Patient was without pain after a couple of treatments and minimizing load (no, running, and shutting down cross country season for the last two weeks.) She just started soccer season, and after the first day of practice has the symptoms return and is clearly inflamed today.
Does the location of the pain indicate anything other than hip? My concerns are morphology and labrum. When loaded they are provoked, and when rested they feel better. What else am I missing? My next step I believe is MRA, is there other things to consider?
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