Sore right hip

Hello,

I have had a sore hip for over a year. My GP ordered an xray 2 months ago which showed slight arthritis only.  I was started on an NSAID with no response.  Last week my GP ordered a CT lumbar spine plus or minus MRI of the hip.

CT spine showed Grade 1 spondylolisthesis L3-L4 and other degenerative changes, no nerve impingement.  MRI hip showed diffuse tendinitis of 2 tendons, bursitis of two bursa and a labral tear.

My GP is making arrangements for a radiologist to inject steroids into my hip under guidance, I've been told to rest until then.

My concern is that it's taken a year for my complaints of pain and limitation of movement to be taken seriously and I'm worried that the condition has become chronic. Is the potential for successful treatment been compromised by taking so long to be diagnosed? Also, no mention was made of treatment for the labral tear.  Would it be too late to treat this?

Thank you for your opinion on this matter.

[S. Kaul, MD]

Hi there!

Well, this is a case that should typically be handled by an orthopedician. For the spinal degenerative changes, management would depend on the severity of the changes and the symptoms and would need to be evaluated by an orthopedician/ neurologist/ neurosurgeon. For the labral tear, management again would depend on the severity of the tear and the associated pathologies, and without knowing the relevant clinical details it would be inappropriate for me to comment on this. While minor tears may be managed conservatively, severe ones may require a surgical/ arthroscopic repair. I am not sure how much expertise would GP’s have in your area, but cases like these usually require an orthopedic evaluation. If NSAIDS have not been fruitful, injectable steroids may helpful in controlling inflammation. Though potential for successful treatment may not have yet been compromised, I would typically like to have the situation evaluated and managed by an orthopedician.
Hope this was useful.

Take care!