Vaz Inês Machado, Castro M, Cabete S, Rocha J A, Brito I
Interno Formação Específica de Medicina Física e de Reabilitação, Hospital S. João, E.P.E.
Acta Reumatol Port. 2009 Oct-Dec;34(4):656-62.
A painful hip in a young adult may have its origin in different aetiologies, and both clinical history and physical examination are crucial for diagnostic guidance. The authors describe the case of a 28 year-old male, amateur football player, suffering from insidious progressive left cruralgia, with nocturnal and prolonged high-impact loading activities exacerbation, resulting in significant impairment of exercise tolerance, gait and other daily activities. He had a transitory response to non-steroid anti-inflammatory drugs. Besides slight limitation of hip internal rotation and an antalgic gait pattern, physical examination was normal. Laboratory tests and conventional X-ray of the left hip were normal. CT and MRI depicted findings compatible with an osteoid osteoma in the femoral cervico-cephalic transition and signs of a potential «cam» type femoro-acetabular impingement. The adopted therapeutic strategy consisted on radiofrequency excision of the nidus of osteoid, with complete clinical recovery after 6 months.
年轻成人的髋关节疼痛可能源于不同病因,临床病史和体格检查对诊断指导至关重要。作者描述了一名28岁男性业余足球运动员的病例,该患者患有隐匿性进行性左下肢疼痛,夜间及长时间高强度负荷活动会使其加重,导致运动耐量、步态及其他日常活动严重受损。他对非甾体抗炎药有短暂反应。除了髋关节内旋略有受限和疼痛性步态外,体格检查正常。左髋关节的实验室检查和传统X线检查均正常。CT和MRI显示的结果与股骨颈-头交界处的骨样骨瘤相符,并有潜在“凸轮”型股骨髋臼撞击的迹象。所采用的治疗策略是对骨样骨瘤的瘤巢进行射频切除,6个月后临床完全康复。