Question: Hi,

I have been dealing with a hip issue for nearly 2 years. I am desperate for help. My doctor seems to have given up, or maybe he thinks I am just after attention or drugs or something. I'll be finding a new doctor soon.

I've uploaded two pictures for side-by-side comparison (or you can visit my Wix site: http://vaarmagh.wix.com/left-hip ). I apologize in advance for the lousy photography, but it was difficult to do by myself.

I've been in PT for over a year. My new PT (who is really smart) thinks it may be a complex issue that is causing other system problems (low back, etc.) due to my compensating for the hip, but he can't pinpoint the root cause.

FABER is almost non-existent... extremely limited ROM - knee drop only goes about 6 inches down from top center; unable to do a straight leg lift supine (much less against pressure); can't lift while lying on my stomach with knee at 90 degrees; unable to lift when lying on my side.

Rebound pain after muscle contraction.
 
Pain is in my groin, in the center of my butt, on the lateral side, and down back of leg to my knee. Sometimes it's almost unbearable.

If I could just get an idea of what it might be, then maybe I could steer a new doctor to look in that direction, but more importantly, perhaps I could get a glimmer of hope for fixing the problem. My entire life has been turned upside down and I'm almost at the end of my rope.

Many thanks,
Ginny

Thank you for your reply, but unfortunately this does not answer my question. While I appreciate your suggestions, I am looking for *new* ideas.

Please LOOK AT THE PICTURE OF MY LEFT HIP. It is clearly not normal. The hinge is weird looking when I try to drop my knee out. Something is mechanically incorrect. Why does it look like this?

My pain management doctor and PT agree that my back issues precipitate from my hip problem. Since I can't sit, walk, move correctly on my hip. I am compensating with my back in destructive ways. I have had facet/epidural injections and SIJ injections, and PT core strengthening, it has helped my back pain. But I still have no range of movement in my hip and IT LOOKS WEIRD.

Something is clearly being missed.

I saw an orthopedic surgeon and had an MRI arthrogram and X-ray, but when nothing jumped out in the scans, he didn't look any closer and just said the same thing you have said, which is what I've been doing for nearly 2 years. This is not helpful.

I am a former equestrian and rode English until I had to stop last XXXXXXX I spent many years/days/hours posting the trot, which is basically a continual squat from the hip. Plus I took a hard fall from a horse about 15 years ago and sublaxed that hip. I'm thinking these things may have contributed to whatever the problem is.

So... by outward appearance, what are the possibilities?
Have you seen anything like it before?
Do you have any colleagues who have seen something like it?
What muscles/tendons might be involved?
Is something torn?
Is something adhered?
Is it dislocating when I try to drop my knee out?
Should I force my knee down to try to unstick it?

I was really hoping to get some new ideas before I start traveling to different regions to see different doctors. So unless you or someone else can suggest anything else, I guess I'll go to a university hospital.

Thank you.

Thank you! While I was hoping for something more definitive, I at least feel like I'm not crazy... there actually *is* something happening there.

Now the questions become why the muscle atrophied like this so suddenly and why my hip hurts so much.

I'll be finding a new doctor beginning tomorrow. I guess I'll head to a university hospital. It's a very long drive, but it might be worth it.

Also, I'll see if I can get a second opinion on the MRI. Maybe something is actually torn or adhered but it was overlooked because they were specifically looking for a labral tear? Or maybe I should have an MRI of my upper thigh muscle instead of my hip?

Thank you again for your second reply. If something else should come to mind, please don't hesitate to drop a note here.

Ginny

Ah, I see what you are getting at. This is something that needs to be explored before it gets any worse.

So a nerve conduction test (like I had on my low back) and an EMG to see if the nerves are sending information to my brain that would normally keep my muscles working. Is this myopathy? My mother died from cardiomyopathy and the doctors were never sure what caused it. This is beginning to get a little scary. I'm definitely going to a university hospital where there is the newest knowledge.

THANK YOU!!!!!

But will this also address the way my hip 'catches'? No ROM - it's stuck.