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Dr. Chip
Dr. Chip, Doctor (MD)
Category: Health
Satisfied Customers: 29302
Experience:  Over 20 yrs of Family Practice
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my 84 y/o mother has extreme swelling on her right hip. Severe

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my 84 y/o mother has extreme swelling on her right hip. Severe pain in her upper thigh radiating down into calf and ankle. The pain has caused her to be bed ridden. Very difficult to sit or walk. Doctor indicated a bursa and put her on hydrocodone 5-500 which barely helps the pain. He upped to 10-325 but that caused her to halucinate and didn't relieve the pain. It has been over a week with no improvement. She has no energy or appetite. Her red blood count is 264 but the hospital said she was not sick enough for a blood transfusion. She is on warfarin.
Hi--has your mother had either an x-ray or an MRI of the hip and leg? What about a venous ultrasound of the leg?
Customer: replied 4 years ago.

She had a hip replacement 13 yrs ago so can't do an MRI. They did a CT scan of hip.

And what did that show?
Customer: replied 4 years ago.

The scan was taken 2 days after the initial appt with the doctor for the swelling. At that initial appointment he gave her a kenalog shot in the swollen hip. It caused a bruise as long and wide as her thigh. 2 days later pain remained extreme and I took her back to doctor. Showed him bruise and he ordered CT. They said scan was normal. that was 9 days ago. She is a little better, can sit up occasionally, with effort. She is eating although not hungry. Very weak. Pain is still high and hip is still swollen.

OK. At this point she not only needs another ct of the hip and thigh but she also needs venous doppler studies of the leg. It sounds as though she has a large hematoma in the thigh (blood collection) and, despite the warfarin she may have a deep venous thrombosis--clot--in the leg and that can be very dangerous. She also needs, if it hasn't been done lately, blood work to look for anemia which would explain here fatigue. In other words she needs immediate medical attention for all of this
Customer: replied 4 years ago.

Dr. Chip - She is anemic and we are trying to get her to eat high protein, red cell producing food. They have been watching her blood work closely. She has a doctors appointment on Monday. Should I talk her to the hospital or wait for the appointment. Is there anything we can do for the swollen hip? The hip looks like she has a 1/2 foot ball attached. The hematoma came after the swollen hip.

If she were already anemic then this may have tipped her over to the point where she needs a blood transfusion since someone her age can't tolerate that low a red cell count. I honestly think the sooner she gets to a hospital the better and no waiting until Monday. For now just bed rest and leg elevation is all you can do for her at home.
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