Hip pain

[ERIC.K]

To satisfy the moderators disclaimers, I'm currently under the care of an MD, and i'm not looking for a diagnosis so here it goes.

about 6 months ago I developed muscle aching in my left thigh that would occasionally radiate to my groin, sometimes the pain would start in my left butt cheek. the discomfort was not unlike muscle aches after running a long distance or the pain one feels the day after working out. I sleep at night on my sides exclusively and the pain is aggravated by lying on either side now. Actually the painseemed to get worse after spending alot of money on a new matress but i having the courage after several months to tell my wife because she sleeps so well on it. I could stand to lose a few pounds. I weigh 240 on a 6 foot frame. I'm semi active and at the gym abot twice a week and run on the treadmill most days. I've spent alot on shoes to run in and had them fitted for me at a running store.
I'm posting here because...well quite frankly if I had to save myself or wife from death whilke diving I'm not certain I could do it because my hip has prevented me from doing the simplest of tasks like putting on socks, The range of motion I have in my hips are next to nothing however that seems to improve with stretching and have appointments this week for therapy. I've had a nuclear bone scan to rule out tumor, i've had seveal x-rays to rule out stress fx, but all they see is moderate arthritis. I have done some research and have located a diagnosis that seems to fit and wanted to throw it by a few that post here. The problem is now that my right hip had entered into about the same path that my left did...same aching, decreased range of motion and as an ER nurse i'm concerned that the problem is now bilateral hips. My first thought was a ascetabular labrium tear....To the life of me I cannot identify and injury and that also seems to be the mo for a tear.....If anyone is able to offer any similar injuries of pain you mighty have had It would be appreciated.....mid October is Turks and Caicos trip...lastly last dive was December 2007 I thought about some type of DCS event in a joint with residual, but I'm not the slightest bit concerned because the last dive was aquarium dive.....Thanks for any help some one might provide, My MD is not convinced it's a tear of the labrium

 

[ERIC.K]

Well this thread isn't setting any new records, I'll update anyone if any who is interested. I needed something done so I finally went to a ortho md and he thought that it might be a labrium tear, so he set up a MR with contrast study. the day the before the procedure I has physical therapy scheduled and went as planned and although I was sore I felt that I had improved......so I canceled the MRI and going to wait until my nest PT appointment to see how much more I've improved. I can actually put on dive booties now, before I had problems simply putting on socks. I'm down 10 lbs so hopefully i'll be back in the water soon

 

[DocVikingo]

Hi ERIC.K,

I'm interested and appreciate the update.

My thoughts in no particular order:

1. "My first thought was a ascetabular labrium tear....To the life of me I cannot identify and injury and that also seems to be the mo for a tear.... (sic)"

Not to detract from the obvious medical knowledge you would have as an ER nurse, but given that you're not an orthopod you shouldn't be too upset or puzzled that you are not able to arrive at a confident diagnosis based on no evidence other than a somewhat vague symptom picture involving pain in the region of the hip.

Since your MD "is not convinced it's a tear of the labrium (sic)," then perhaps what you are experiencing is not the "mo" of what I believe you mean to describe, that is an acetabular labral tear.

As regards this injury, it is characterized by diffuse and difficult to localize hip pain and "catching" of the joint when performing certain movements. It is most frequently caused by a vigorous twisting movement while the hip joint is bearing weight.

Given that you're "...concerned that the problem is now bilateral hips," be advised that unless you play some real mean sports, it seems very unlikely that you'd develop bilateral acetabular labral tears.

2. "...I finally went to a ortho md ....(sic)"

That would appear the sensible course of action given your complaints.

However, having consulted an expert who set up an MRI with contrast, it's not clear why you'd take it upon yourself to cancel it simply because you thought you might have benefited from a single session of PT. It would appear prudent to undergo this procedure even if additional sessions of PT do yield additional improvement.

3. "I can actually put on dive booties now, before I had problems simply putting on socks. I'm down 10 lbs so hopefully i'll be back in the water soon. (sic)"

That is good news. Under circumstances such as you describe, weight loss and proper exercises often provide some relief.

Please keep us posted on your progress.

Regards,

DocVikingo

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice.

 

[ERIC.K]

Thanks Doc, It pains me to know that right now I'm unfit to dive so i'm very happy to hear that someone is interested. I initially started out my treatment with my family MD. He was not convinced that it was a labriam tear so he simply scheduled the PT and felt that if that didn't work then we would proceed to more complexed studies. Well quite frankly last Friday I was in absolute agony and needed something done so I called a Ortho group which we frequently have dealings with from the ER and one of the Docs in the practice had an opening, So unfortunatly if I simply stuck with my family MD I might not have reached the ortho yet, So I'm kinda stuck in between the care of two MDs, one who wanted to try therapy and one who wants to go to the MRI. Being that I pride myself with having great relationships was almost all of the MDs I work with it pains me to know that I've put myself in this position. My plan is to finish the week with PT and speak with both MDs offices and see in which way they would like to go with this....Thanks for listening......Eric

 

[vladimir]

I'm currently under the care of an MD, and i'm not looking for a diagnosis so here it goes.

This is great, Erik. If everybody typed this and then added, "I have already spoken with DAN," we could eliminate most of the extraneous posts in this forum. Except for mine, apparently.

 

[DocVikingo]

Hi ERIC.K,

There is nothing inappropriate about a patient seeking the opinion of a specialist even though a PCP has already offered advice, seeking immediate treatment from an alternate physician when experiencing extreme pain, nor getting a second opinion under any circumstances.

Understandably you are upset and worried about your diagnosis, pain and lack of present fitness for SCUBA. However, speculating about etiologies, diagnostic techniques and treatments when one isn't qualified to do so, and worrying about bruised physician egos when in fact there is no evidence that such will occur, really doesn't appear productive or salubrious.

Attending scheduled PT sessions and at the earliest possible occasion again conferring with both physicians involved, with full and honest disclosure of the actions being undertaken, seems a good plan.

In the meantime, not getting too far ahead of yourself and remaining as calm and relaxed as possible will ease the anxiety. Engage in those activities that you enjoy and can do without significant discomfort.

Regards,

DocVikingo

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice.

 

[ERIC.K]

If anyone is still interested, after 3 different orthopods, 2 of which were in the same group, it has been decided that I have simply pulled the short straw with regards to early degenerative joint problems and arthritis. After the regular MRI, no avascular necrosis, a possible small labral tear was identified in my right hip. seems like frequent stretching, celebrex, physical therapy is the course of action to preserve what joint spaces and cartilege I have left which the ortho guys agree is workable. Range of motion has improved and the affliction if you will has given us an excuse to purchase our 7 person hot tub that was delievered last week end....When asked if he would have considered a hip replacement for me, his response was i'm not even on his radar. lastly he also told me that he had just replased the hips of a 22 year old..so I have really nothing to complain about...next time your on a dive boat and you see someone sorta gimpy, say hi won't you