SCENARIO: A 20-year-old Olympic female ice hockey athlete re…
SCENARIO: A 20-year-old Olympic female ice hockey athlete reports to you complaining of left groin and hip pain. History She tells you that the pain has gradually become worse over the course of a month. She does not recall a specific mechanism of injury. Physical activity, especially intensive effort skating during practices, exacerbates her pain. She has also noticed that sitting for prolonged periods tends to aggravate her pain, especially when cycling. She did not make any substantial changes to her training regimen before experiencing this pain. Her primary complaint is pain that she describes as deep and spans along the anterior and lateral aspect of her hip. She reports that the pain periodically extends to her low back. However, she does not complain of any abnormal sensations other than an infrequent clicking when in deep positions of hip flexion, adduction, and internal rotation. After one week of persistent pain, she sought treatment from a massage therapist who performed trigger-point release and prescribed routine stretching of her hip flexors and adductors. This and taking a week off from training/practicing seemed to improve her condition. However, the pain resurfaced almost immediately after resuming training and practicing. She habitually ices her hip and groin or does a cryotherapy bath after each training/practice session but this has not significantly helped. Over the last two weeks she has elevated her use of OTC NSAIDs to help manage her pain, particularly with heavy training bouts. She recalls suffering from a femoral stress fracture a few years ago. However, she does not recall what that specific diagnosis was. AT RESPONSE: Based on the patient’s history, what corresponding conditions are you considering in the first step of differential diagnosis? DIRECTIONS: Bullet your individual text entries. Your entries must be concise, specific, and accurate. Your entries must include correct spelling. You may (and are encouraged) to use common abbreviations and acronyms linked to anatomical and medical terminology when appropriate.
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