Dr. Vivek Chail
General Practitioner
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
Answered by
Medically reviewed by
Patient's Query
Hello doctor,
I have had left hip pain for two years. I had hip pain following a bicycle ride and was admitted to the hospital for severe lower back pain on the left side. At that time, I was treated with muscle relaxants, painkillers, and physical therapy. I have on and off left hip pain for the last two years. I am not able to do running, cycling, long-distance walking, prolonged sitting or standing, and specific activities provoke pain. I am continuing physical therapy and medications. I am attaching my recent magnetic resonance imaging (MRI) reports. Kindly provide your opinion on the MRI images of the left hip. Thank you.
Hello,
Welcome to icliniq.com. I read your query and understand your concern. I have reviewed the attached images (attachments removed to protect the patient's identity). Here is a review of the left hip's magnetic resonance imaging (MRI). 1. Articular cartilage is preserved in both articulating surfaces. No significant joint effusion. No intra-articular loose body. 2. Head and neck of the femur appear normal. 3. The acetabulum appears normal. 4. Sacro-iliac joints included in the study region appear normal. The only finding which might contribute to left hip pain is a suspicious inflammation of the gluteal tendon attachment in the lateral part. However, I am not completely convinced that only this might be causing your symptoms. Please share the further details provided by your radiologist. Thank you.
Patient's Query
Hello doctor,
Thank you for your response. The radiology opinion for the MRI is shared below: 1. Indication - left hip pain; the strain of left piriformis. 2. Technique - Magnetic resonance imaging (MRI) of the left hip is performed utilizing coronal STIR and T1 axial sequence as well as fast spin echo, coronal, sagittal, and axial oblique sequence. 3. Comparison - No prior studies were available for comparison at the time of dictation. 4. Findings - Pubic symphysis is intact. No tear of the synchondrosis or adductor plate and no fracture of the bony pelvis. 5. No hip fracture - No avascular necrosis. The contour of the femoral head-neck junction is preserved on non-oblique axial imaging, and no capsular tear. 6. Mild hip joint narrowing, trace joint effusion, and anterior superior labral tear. 7. Gluteal tendons are intact, and no bursitis. 8. Fat planes around the sciatic nerve are intact. Hamstrings are intact. No muscle atrophy or tear and no narrowing of the ischiofemoral interval. 9. No enlarged lymphadenopathy and no free fluid in the pelvis. 10. Impression: Anterior superior labral tear and mild hip joint narrowing with trace joint effusion. Thank you.
Hello,
Welcome back to icliniq.com. I read your query and understand your concern. My comments are: 1. The anterior superior labral tear is a condition that is best visualized in arthrography or when there is significant effusion. Though there is a small altered signal area in the anterior labrum, it is difficult to confirm this finding with accuracy in routine magnetic resonance imaging (MRI) due to technical reasons. In this context, I prefer not to stress much about the finding in the given images. 2. The fluid in the joint is mentioned as a trace, and such amounts of fluid are usually not of significance and are visualized in many normal subjects. 3. The decreased left hip joint space is something I do not completely agree with. This is a subjective view; honestly, I do not find many variations in the left hip joint space compared to the right hip. As there is mention of piriformis strain in the clinical history, I suggest you discuss with your doctor regarding a lumbar spine MRI to search for any other causes of your problems. For example, you may have conditions in the spine causing hip pain even if there is no lower back pain. I hope I was helpful to you. Thank you.
Was this conversation helpful?
Same symptoms don't mean you have the same problem. Consult a doctor now!
General Practitioner
Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.
This website uses cookies to ensure you get the best experience on our website. iCliniq privacy policy
