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Phophalia, I have found you most helpful and responsive in…

HI Dr. Phophalia,I have found...
HI Dr. Phophalia,I have found you most helpful and responsive in the past.Hi,I had an elevator at work close on my left hip last December. The hip hurt for a few weeks to the point I wore my jeans to bed. I had X-Rays taken that were negative, and was diagnosed as a contusion to the upper Iliac crest..The workers' compensation doctor said in March that theseinjuries can take a while to heal, and to get back to him later if still felt sorenesss. I have an appointment lat this afternoon with him because the area, although better, is still sore. The soreness level can vary; I don't think any limitation of movement is present.What would you recommend I ask the doctor today? Would an MRI be advisable at this time? If so, would contract be necessary? Thank you.Fast approval for quick reply. Thank you!
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Answered in 3 hours by:
7/18/2018
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 39,051
Experience: MBBS, MS (General Surgery), Fellowship in Sports Medicine
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Welcome to Just Answer.
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I am sorry for the delayed reply. I was offline the whole day as busy in the operating room.

Ideally, an MRI should be done.

This will tell, what are the tissues involved:

1) Muscles

2) Joint

3) Ligament

4) Tendon

5) Bursa

6) cartilage

7) Or any combination.

A persistent pain lingering for around 7 months require further evaluation.

Please feel free for your follow up questions.

I would be happy to assist you further if you need any more information.

Thanks for using Just Answer.

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Was this information helpful to you? I would be glad to answer any further questions.

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Customer reply replied 27 days ago
Just saw your response. Need to get to bed, but will get back to you tomorrow with results from doctor and your observation of doctor's statements. Thanks.

You are very welcome.

Sure, will like to see your doctor's statement.

My best,

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Customer reply replied 26 days ago
The physician felt the area where I am experiencing intermittent mild pain. He stated he suspected bursitis. HIs diagnosis was, "left hip contusions, subseq, bursitis of left trochanteric bursa. He order an MRI, and said that potential physical therapy depending upon the results of the MRI. He mentioned the use of ultrasound in treatment. He also mentioned possible cortisone injection.I feel the soreness most if I cross my right left over and perpendicular to my left thigh. The pain is intermittent and mild, but some concern that still present after 12/18/17 elevator incident. My initial X-Rays showed no fracture, but some arthritis of hips, but not abnormal for my age.Your views of condition, diagnosis, and potential treatment. About a decade ago I had bursitis in my right should that went away after physical therapy.

MRI should be done for an injury which has caused pain beyond 2 weeks or is causing moderate to severe pain.

MRI should also be done to assess the extent of injury and structures involved.

Bursitis, soft tissue like ligaments, muscles, cartilage can only be assessed by the MRI.

The specific questions to your physician would be;

Why is the pain lingering?

What would be treatment done?

What are the further investigations needed?

What is the prognosis?

It is privilege assisting you.

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Following causes would be considered for your pain;

1) Trochanteric bursitis

2) Gluteus medius bursitis
3) Gluteus medius partial tear
4) Iliopsoas bursitis
5) ITB tendinitis

MRI and ultrasonography scans are able to differentiate the conditions. Though a clinical diagnosis by a physical examination by an orthopedic doctor also would be usually conclusive.

Treatment entails;

1) A specific and goal-directed Physical Therapy program; stretching exercises have a significant role

2) Transcutaneous electrical nerve stimulation (TENS) can be considered in resistant cases.

3) Iontophoresis and phonophoresis (therapeutic ultrasound)

4) Shortwave diathermy

5) Anti-inflammatory analgesics

6) Local analgesic cream / ointment / patch / spray

Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 39,051
Experience: MBBS, MS (General Surgery), Fellowship in Sports Medicine
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Customer reply replied 24 days ago
Thank you for your comprehensive reply.
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