Background – Anterior hip pain

This anterior hip pain case will test your knowledge of pathologies that can cause anterior hip pain, your interpretation of information in the history and your ability to plan the physical examination and rehabilitation.

Minimum Level

New Graduate Physiotherapist

History

Sue is a 45 year old active lady with a desk job. She has noticed worsening Left anterior hip pain that commenced six months ago without any incident that she can recall.

Does the lack of an incident to trigger the onset of pain help narrow your diagnostic hypotheses? How so?

Sue enjoys hiking and outdoor exercise classes, and has done both these activities for a number of years.

Do you think that these activities may be a consideration for your diagnosis and/or rehab plan?

The Left anterior hip pain is described as sharp with a residual ache.

How might the quality of pain impact your diagnostic reasoning?

The symptoms are aggravated by prolonged sitting, doing up shoelaces and grocery shopping.

Are there any common elements to these aggravating factors?

Do you need to ask further questions to clarify any specific details?

Sue tried NSAIDs early on and found them helpful without getting any long-lasting relief from them.

What further questions do you need to ask about Sue’s NSAID use to assist your assessment?

Sue decided to present to Physiotherapy due to the gradually increasing nature of the anterior hip pain and that it’s now interrupting her sleep.

Are you concerned about any red flags? Justify your reasoning regarding these red flags.

Further questioning

What additional information would you like to know from Sue?

What are your provisional diagnoses at this stage?

Physical examination

Plan your physical examination

Justify each test, the expected outcome and the information gained

Imaging

Would you consider any imaging for Sue?

Discuss the limitations of any imaging requested

Rehab planning

Design a rehabilitation plan for Sue

Specify the timeframe for any noticeable change in symptoms


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