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Abstract

CASE HISTORY: The patient is a 19-year-old collegiate baseball infielder who presented with an ongoing pain in his left hip that had originally presented when the patient was in high school. After becoming a member of a collegiate baseball team, his hip pain persisted, followed shortly by a new pain in his right hip. The patient had been dealing with and conservatively treating the left hip pain for a year, and with the presentation of right hip pain during his first collegiate semester a decision was made to visit the team physician. PHYSICAL EXAM: Examination of the patient’s hips determined no visible deformities or abnormalities, no obvious leg length discrepancy, and no point tenderness. Patient tested positive for Hip Scouring and Patrick (FABERS). Patient had close to full range of motion, but movements were accompanied by pain. Patient had decreased strength with the left hip and experienced most pain during squatting. DIFFERENTIAL DIAGNOSES: Labral tear; Gracilis strain; Sartorius strain; Inguinal ligament sprain. TESTS & RESULTS: Patient had x-rays taken of both hips, which reported bony outgrowths and labral tears inside each hip joint. FINAL DIAGNOSIS: Double Femoroacetabular Impingement. DISCUSSION: Femoroacetabular impingement is a condition that involves a bony outgrowth on the head of the femur, a bony growth within the hip socket, or both, as in the case with the patient. This type of condition can occur due to genetic predisposition or from excessive physical activity. In the case of the patient, a combination of genetic predisposition and excessive physical activity is what resulted in having double femoroacetabular impingement. OUTCOME OF THE CASE: Following the patient’s diagnosis, a discussion of surgery was had, due to one side needing to be repaired no matter what. The patient’s upcoming season was discussed as well, seeing as how whether surgery was done or not, the patient would miss the upcoming season regardless. The patient agreed to go through with the surgeries, as it would put him going through one rehabilitation plan for both hips, instead of two separate rehabilitation plans. RETURN TO ACTIVITY AND FURTHER FOLLOW-UP: Patient completed 6 months of rehabilitation and was able to return to play in May of 2020.

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