Wk 4, Case 2 - Review

Patient History: 33-yo female with chronic right hip pain and decreased ROM
Findings
SKELETAL: No acute macrofracture. No infiltrative or destructive bone lesion.

PELVIS: No free fluid. Physiologic free fluid. No hernia.

JOINTS: Complex right femoroacetabular joint fluid collection with multiple tiny foci of debris/bodies in the joint space compatible with rice bodies.

ACETABULUM/LABRUM: Acetabular spurring and anterolateral labral tearing.

MUSCLES/TENDONS/LIGAMENTS: Normal right hamstring. No ischiofemoral impingement. Partial tear of the right gluteus medius middle segment. Undersurface partial tear of the anterior fibers of the gluteus minimus. No avulsion fracture, underlying bony stress change or enthesopathy. Normal iliopsoas.

OTHER/SOFT TISSUE: Mild gluteal muscle atrophy. The pelvic and extrapelvic musculature is otherwise normal. No lymphadenopathy. No soft tissue mass.

Conclusion
1. Joint space loss, synovial thickening, rice bodies and axial migration of the femoral head compatible with inflammatory arthropathy given history of rheumatoid arthritis. Superimposed moderate to severe osteoarthropathy. Right acetabular labral tear. No AVN.
2. Gluteus medius and minimus peritendinitis, tendinosis and partial tearing without retracted rupture.