Case Study: Anne (04:19)
Timothy Mazzola introduces the case of a 39-year-old runner who has experienced posterior hip pain on the left side for six weeks. Location is important for diagnosis.
Case Study: Peter (01:40)
Mazzola introduces the case of a 38-year-old soccer player who has experienced atraumatic left-side posterior hip pain for five years.
Anterior and Lateral Hip Pain (04:23)
Mazzola reviews hip joint disorders and extra-articular causes. See a slide that highlights three referral patterns of hip pain based on the cause.
Posterior Hip Pan (03:52)
The differential diagnosis for this type of pain varies including: lumbar radicular pain, SI joint/ lumbopelvic dysfunction, sciatica or Piriformis syndrome, proximal hamstring tendinopathy, ischial spine avulsion of hamstring, OA, or labral tear. Mazzola provides clues to consider when reviewing Anne and Peter's case studies.
L5-S1 Herniated Disk (04:14)
See images of a herniated disk. A lumbar radiculopathy exam includes: straight leg raise test, crossed leg raise test, and looking for signs of motor weakness, sensory deficits, and decreased reflexes.
Sacroiliac Joint (02:44)
Sacroilitis is an accepted cause of pain; review SI joint anatomy. Learn potential causes of sacroilitis and tips for evaluation.
Sacroiliac Joint: Joint Pain (03:40)
SI joint injections may be helpful in reducing pain. Mazzola highlights four validated SI joint pain provocation exams and considers an SI joint with a disc bulge and no neurovascular findings.
SI Joint Dysfunction (04:15)
Small amounts of motion occur in the SI joint. Mazzola discusses studies that consider the possibility of clinically diagnosing joint dysfunction and clinical detection of movement without radiographic movements.
SI Joint Dysfunction: Movement (03:01)
Muscular forces act about the pelvis in three planes. Mazzola believes movement that appears to stem from the SI joint has more to do with muscular imbalances than joint movement.
SI Joint Dysfunction: Tight vs. Weak (02:07)
Mazzola explains a sagittal look at the pelvis and clinical associations with SI joint or myofascial lumbopelvic imbalance.
SI Joint/Lumbopelvic Imbalance (01:46)
Tests to help diagnose imbalance include: standing flexion test, sitting flexion test, and March test. See possible diagnoses and treatments.
Piriformis Syndrome (02:25)
Review the anatomy of the piriformis. Learn the symptomatic history associated with piriformis syndrome.
Posterior Hamstring Tendinosis (01:33)
The proximal hamstring can be a source of posterior hip pain; review the anatomy. Mazzola explains images of a normal proximal hamstring and one with tendinopathy.
Mazzola recaps the diagnostic challenges of posterior hip pain and possible causes.
Credits: A Pain in the Butt: Diagnosing Posterior Hip Pain (00:26)
Credits: A Pain in the Butt: Diagnosing Posterior Hip Pain
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