Practice Management
One afternoon, a 47-year-old man presents in the urgent care with left hip pain that he says just started in the past day or so. He says he hasn’t had any injuries or falls. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case can be found by clicking “Solve this Case” below.
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The patient is a 36-year-old male who presents with left hip pain for “years.” The pain is motion- or position-related and over time there has been occasional pain in his buttock, back, and thigh. Additionally, he has stiffness, clicking, locking, and catching. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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A 47-year-old male presents to your urgent care center with an exacerbation of chronic hip pain. The patient offers little by way of explanation; he reports he’s felt discomfort in his right hip “for years,” but that it’s grown worse recently. View the images taken and consider your next steps, along with possible diagnoses.
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Case An 80-year-old woman presents to an urgent care center with left hip pain that she has had for 4 years but that has worsened in the last week. She reports that before the pain worsened, she had gone on a long walk with her grandson. The pain is worse with movement through the range of motion. She has taken ibuprofen, but it did not reduce her pain. She says that she has not had …
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A 62-year-old woman presents to an urgent care center with severe left hip pain that began several hours earlier after a motor vehicle accident. She was the driver, and she was wearing a seat belt. Her car’s driver-side air bag deployed when her car, moving at about 35 miles per hour, rear-ended a stopped car. She refused to be transported from the accident scene by emergency medical services for treatment because her only issue was …
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A 67-year-old woman presents to an urgent care center after 12 hours of pain in her right hip that began after she slipped in her kitchen and fell onto that hip. She reports that the pain is constant and worsens with walking. She has not experienced numbness in the hip, and she reports no other injuries. She has not sustained any head trauma, and she has no head or neck pain. View the image taken …
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The patient is a boy, age 2 years 8 months, who presents with the complaint of pain in the left leg that started five hours ago. There is no history of trauma. On exam, the child looks well and has a temp of 98.96 degrees (axillary) and a pulse of 114. In addition, he has a WBC of 17.7, with 73.7 percent granulocytes. The child\’s leg has no external findings. There is clear pain on …
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The patient is a 16-year-old girl who received a blow to the right hip when she fell in her bathroom at home. She is able to ambulate, albeit with great pain and guarding of her right leg. Her vital signs are stable. View the x-ray taken and consider what your diagnosis and next steps would be.
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The patient is a 3-year-old girl who presented to the urgent care center with right hip pain. She has no fever, and the parents report there was no trauma. The child has a limp and reproducible pain on external rotation of the right hip. White blood count is 11,900 with 40.7 lymphs. The erythrocyte sedimentation rate (ESR) is 3 mm/hour. The x-ray shows fluid around the right hip joint; this finding was confirmed by ultrasound. …
Read MoreA 3-year-old girl presents to the urgent care center with right hip pain. She has no fever, and the parents report there was no trauma. The child has a limp and reproducible pain on external rotation of the right hip. White blood count is 11,900 with 40.7% lymphs. The erythrocyte sedimentation rate (ESR) is 3 mm/hour. The x-ray (Figure 1) shows fluid around the right hip joint; this finding was confirmed by ultrasound. View the …
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