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Old 02-12-2013, 11:54 PM   #2
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Re: Sudden: Intense Anterior Left Hip Pain: Post Laminotomy

Hi there -- I have been off-line since you posted; sorry if this post is after your appointment. X-rays are usually a solid indicator of hip impingement, a major risk factor for labral tears. (If you have never had a significant injury to the hip and have no impingement, then probably not a labral tear. Fingers crossed!) However, you will probably need an ortho/sports medicine specialist to read the X-rays, perhaps even a hip specialist.

After three hip scopes to deal with impingement, a labral tear and labral delamination, I am still dealing with a similar catching and pain, which is relieved when my hip pops. My hip doctor seems to think it might be muscular, but we have decided to see if the pain continues to improve.

At my first thorough examination by a sports medicine doctor, he spent over an hour, checking range of motion of both hips, measuring for leg length discrepancies, testing strength of both legs, and attempting to recreate pain. The pain was recreated with a recumbent straight-leg raise with resistance. (Lie flat on back, lift one leg with knee straight, with someone pushing down.)

Short of surgery, I had an injection for bursitis, which was a side-effect of the joint issue. I also went through tons of physical therapy, which I think ultimately helped with surgical recovery. As you probably know, an MRI with simultaneous gadolinium and marcaine injection is typically the best diagnostic tool. The marcaine numbs the joint for 8-12 hours, and if the pain is relieved, then the source of the pain is definitively coming from the joint.

The injection is not fun; if this procedure ordered for you, be sure that the facility uses lidocaine to numb the skin surface. My first two injections were performed by a surgeon who used a plastic stylus looking device to "desensitize the skin" before the injection. I guarantee he's never had the procedure performed on him. Look for another facility if they use this technique. With the lidocaine, there's uncomfortable pressure but much better than the alternative.

I hope your appointment went well today.