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DOI: 10.2519/jospt.2011.0404
The patient was a 33-year-old man who was referred to a physical therapist following a right ankle sprain. While the patient reported decreased pain and improved function of his right ankle over the course of care, he complained of a new insidious onset of right anterior hip pain. Radiographs of the hip were negative. The patient was treated by the physical therapist 4 times over the next month with manual therapy and therapeutic exercises, which resulted in moderate but temporary relief. Given the lack of response to conservative management and the poor sensitivity of conventional radiographs for early stage pathology, the physical therapist ordered a bone scan, which revealed increased radiopharmaceutical uptake in the lesser trochanteric region of the hip. A computed axial tomography scan revealed a lytic lesion in the proximal right medial femur corresponding to the area of increased uptake on the bone scan, and magnetic resonance imaging demonstrated an intramedullary lesion of the proximal femur. Following a needle biopsy, the patient was diagnosed with eosinophilic granuloma.
J Orthop Sports Phys Ther 2011;41(2):119. doi:10.2519/jospt.2011.0404
KEY WORDS: computed tomography, femur, magnetic resonance imaging, radiography
The patient was a 33-year-old man who was referred to a physical therapist following a right ankle sprain. While the patient reported decreased pain and improved function of his right ankle over the course of care, he complained of a new insidious onset of right anterior hip pain.
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