I am a 44-year-old male. I have left hip pain for two and a half months. Left hip pain started gradually two and a half months back while doing repetitive hip hyper flexing exercises, jogging, and stretching exercises. Initially, the pain is present on the back of the hip, while doing exercises and along with leg cramps. After some time, leg cramps disappeared, and pain is localized to the hip (C-shaped area around the hip) and when severe radiates to the lateral aspect of the thigh up to the knee. Pain is initially cramping and lately throbbing poking in nature and less than 5/10 and intermittent. Recently pain has increased sometimes reaches to 8/10, especially at night. Pain is partially relieved with pillow support under the thigh and analgesics. From four to five days it is not relieved by any support and is not able to find the position of ease, supine position in bed. It awakes me from sleep sometimes. I am getting a lot of pain in my hip while getting in and out of the car and wearing my pants. Pain is also felt while working in a sitting position in front of the computer desk. One week back my right ankle was swollen suddenly, without injury, and unable to bear weight on that leg. The swelling and pain in the right ankle decreased in three to four days with analgesics.
Past history: No pain in the hip before. Mild hypercholesterolemia (Lipitor 10mg). No DM, not a known hypertensive. Endoscopic sinus surgery for sinusitis. For occupation INH testing positive, IGRA positive. Used INR for two months and stopped on the advice of the primary care provider for muscle cramps. Later started on B6 vitamin.
Medications: Ibuprofen 200 mg for a few days followed by Naproxen for one week, and Cyclobenzaprine for a few days. Stopped because of sedation and local analgesic ointment. Only gave partial relief gave one intramuscular steroid shot and Toradol shot.
Personal history: not a smoker, not an alcoholic.
Family history: Mother has OA of knee, psoriasis on finger joints (flare-ups sometimes), no DM, no HTN. Father: OA, HTN, DM+.
Physical Examination: No restriction of hip joint movements, but pain on flexion, adduction and internal rotations and flexion abduction, and external rotation. Mild tenderness at the left trochanteric area and hip joint. Power:5/5 in all groups of muscles. No distal neurovascular deficit.
Labs: primary care provider at the university hospital did CMP for muscle cramps. Basic arthritis profile and CBC with differential.
Imaging: MRI hip without contrast.