Ask a PT

156 Posts
 
Posted - 02/12/2008 :  23:55:59  Show Profile  Reply with Quote
Our user asked: "For the past week, the male 58 year old patient has had R anterior thigh pain, cannot sit, sitting on toileting is almost unbearable, pt wants leg traction. Pt went to chiropractor and reported that the chiropractor took an X-ray, that the pain was from contralateral side, and that one leg is shorter than the other. The Chiropractors adjustment worked temporarily. I stretched hip adductors and that temporarily normalized gait . Patient is on Lipotor for HBP, was exposed to Agent Orange in Vietnam, and last time checked his PSI has increased from 1 to 2. What is the best course of treatment?"

Ask a PT Response: "From what you describe, it sounds like your patient may have a sacroiliac dysfunction which may be contributing to his sx. Anterior thigh pain is not as common compared to posterior buttock/thigh/LE pain for a SI dysfunction but certainly plausible. You mention the work done by the chiropractor results in temporary relief from pain and that your patient has a leg length discrepancy. The chiropractor is on the right track with the adjustments but nothing is being done to help make the adjustments permanent. What you would want to do is to determine where the SI dysfunction is coming from and to treat it. I think you will find the link here helpful: http://www.sahs.utmb.edu/programs/pt/Courses/6501%20TIV2/SI%20Ex%20Lab.doc - http://www.sahs.utmb.edu/programs/pt/Courses/6501%20TIV2/SI%20Ex%20Lab.doc . Good luck with treating your patient and let me know if you have any questions."

kiwi

USA
1 Posts
 
Posted - 02/26/2008 :  20:48:09  Show Profile  Reply with Quote
Motion paplation ain't the greatest with interrate reliability, no doubt cyberpalpation is worse.

More info is clearly needed but I'd be more concerned with hip pathology in my DDx, FAI, labral tear, OA. What is hip ROM, how does combined hip flex add and IR feel to him?