Dr. Atul Prakash
Orthopedician and Traumatology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I am a 61-year-old female with dull aching pain in the left thigh close to the inguinal ligament corresponding to iliopsoas insertion, which has been severe in the night for the past month. It radiates up in the abdominal wall and down in the anterior thigh. My symptoms started after three months of walking uphill and downhill for 30 minutes daily. I stopped walking for one month. MRI scan of the lumbosacral spine, X-ray of the pelvis including both hips, USG of abdomen and pelvis, and DEXA scan were done, which indicated osteopenia. Kindly help.
Hello,
Welcome to icliniq.com.
I understand your concern. I have seen your reports (attachment removed to protect the patient's identity), and based on that, there are two possibilities. It can be osteoarthritis of the hip causing thigh pain or disc degeneration and nerve root entrapment. I will like to know more about the symptoms, causative and relieving factors, intensity of pain at rest and night, and when you walk uphill or downhill, response to medication, difficulty with activities, recent trauma history, and current weight. In addition, I would like to see the x-ray and MRI (magnetic resonance imaging) of the pelvis, hip, and spine to assess the reduction of joint space and nerve root entrapment. Kindly revert for more queries.
Thank you.
Patient's Query
Hi doctor,
Thank you for your reply.
MRI of the hip and pelvis shows Gluteus minimus tendinitis at its insertion site of the greater trochanter. Last month I tried a muscle relaxant with Acetaminophen and Ibuprofen 400 mg twice weekly. Did ultrasound therapy followed by ice daily for three days. The pain is relieved during rest and normal walking and aggravated when walking uphill or downhill. There is no pain in the day. However, sometimes getting up after a long time of sitting gives mild stiffness in the inguinal region, and mild pain radiates to the groin and abdomen. If I exert more, the pain radiates up to the knee. Pain is present all day long after driving for 30 minutes. I also met with a car accident seven months ago. Can this be the cause of this pain? But symptoms started three months after these incidents. I cannot avoid uphill or downhill walking as I work in a hill station. My current weight is 70 kg. Kindly help.
Hello,
Welcome back to icliniq.com.
I saw your reports (attachment removed to protect the patient's identity). I would suggest you continue with ultrasound treatment.
Kindly revert for more queries.
Thank you.
Patient's Query
Hi doctor,
Thank you for your reply. Are there any other specific tests or scans needed to be done? Is MRI suggested for the pelvis and hip?
Hello,
Welcome back to icliniq.com.
I would suggest:
Thank you.
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Orthopedician and Traumatology
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