The Journal of Bone and Joint Surgery

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Acute Onset of Hip Pain in a Sixty-four-Year-Old Woman¹
A sixty-four-year-old woman had a sudden onset of severe pain in the right hip when she bent to pick up something from the floor. The pain persisted, even at night, and a limp developed. She presented for evaluation five weeks after the onset of symptoms. There was no history of steroid therapy or alcoholism. The patient's height was 157 cm, she weighed 82 kg, and the body mass index (33.3) indicated obesity. On examination, the range of motion of the right hip was slightly limited (115° of flexion, 40° of abduction, 20° of adduction, 15° of external rotation, and 20° of internal rotation).
An anteroposterior radiograph was made (Fig. 1).
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Fig. 1	Fig. 2
Oral anti-inflammatory medication was prescribed. Three weeks later, the patient's symptoms had not improved. A second anteroposterior radiograph was made (Fig. 2), and magnetic resonance imaging was acquired (Figs. 3-A and 3-B).
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Fig. 3-A	Fig. 3-B