1. clinical case hip pain dr shrenik shah SHREY HOSPITAL

2. M/ 40 radiographer had persistent hip pain since 1 year
Unable to sit cross legged
ADL not much affected
No rest pain or sleepless nights
No fever or constitutional signs
All lab investigations were normal
Clinical picture

3. XRAY

4. Femoroacetabular impingement
The impingement causes repeated minor damage to the labrum & edge of the acetabulum. This results in labral tears (which can be painful) & damage to the cartilage lining the hip joint

5. DIFFERENTIAL DIAGNOSIS OF fai
• Low back pain
• Trochanteric bursitis
• Piriformis syndrome
• Sports hernia (abdominal muscle strain)
• Groin or thigh strains
• Iliopsoas tendinosis
DIFFERENTIAL DIAGNOSIS OF fai

6. impingement test for problems in the front of the hip.
reverse impingement test for problems in the back of the hip.
Provocative tests

7. MRI

8. Treatment of FAi Non operative Surgery
A less active lifestyle, possibly with cortisone injections, physiotherapy advice or rest. (Although a good physiotherapy program focusing on hip strengthening may be beneficial, the stretching associated with yoga may make the symptoms worse).
Arthroscopic hip debridement
Open surgery
Treatment of FAi

9. ESWT- extracorporeal shock wave therapy- orthotripsy WWW.ESWTINDIA.IN

10. FINAL RESULT 9 months follow up
No pain
Nearly full range of movements
Does swimming daily
Fit to to do all duties
FINAL RESULT 9 months follow up

11. CASE 2
X ray
M/62 Dr having Diabetes, hypertension, obesity and Asthama
chronic LBP and left trochanteric pain radiating to thigh and knee
Inability to sit cross legged and squatt
Spine Xrays and MRI were normal
Pain progressive with limp
ADL affected due to limitation of flexion of left hip

12. Case 2 MRI
MR arthrography

13. ESWT

14. FINAL RESULT AT 1 YEAR

15. Thank you