Wk 3, Case 1 - Review

Patient History: 14-yo female with left hip pain.
Findings
SKELETAL: No macrofracture. No infiltrative or destructive bone lesion. Open physes without injury.

PELVIS: No free fluid. No hernia.

JOINTS: Normal SI joints. Increased signal within the symphysis pubis without stress fracture. No internal derangement of either hip.

ACETABULUM/LABRUM: Left acetabular labral fraying and fissuring without full-thickness tear. No acetabular stress reaction or fracture. No loose body.

MUSCLES/TENDONS/LIGAMENTS: Bilateral quadratus femoris muscle edema without atrophy. Narrow ischiofemoral interval bilaterally, though worse on the left. Intact hamstring origins. Intact gluteal insertions. Normal iliopsoas tendons.

OTHER/SOFT TISSUE: Physiologic inguinal lymph nodes without pathologic lymphadenopathy. Mild leftward lumbar curvature. Schmorl nodes at L5-S1.

Conclusion
1. Bilateral quadratus femoris muscle edema without atrophy. Narrow ischiofemoral intervals. Findings may reflect ischiofemoral impingement. Bilateral quadratus femoris strain is the primary differential.
2. Increased signal within the symphysis pubis could reflect osteitis pubis or artifact, no stress fracture.