Updated: 6/3/2017

Iliac Crest Contusion (Hip Pointer)

Topic
Review Topic
0
0
Questions
1
0
0
https://upload.orthobullets.com/topic/3090/images/hip[1]_moved.jpg
Introduction
  • Mechanism direct trauma or crushing
    • common in contact sports 
  • Pathoanatomy
    • hematoma occurs into area surrounding iliac wing
      • and can cause bleeding into hip abductor muscles
    • rule out avulsion of the iliac apophysis
      • in adolescent patients
Anatomy
  • Iliac crest is origin of several muscles any of which can be involved 
    • sartorius 
    • tensor fascia lata 
    • gluteus medius 
    • abdominal muscles
      • transverse or oblique muscles 
Presentation
  • Symptoms
    • pain near iliac crest
  • Physical exam
    • contusion and hematoma near iliac crest
    • affected hip weakness
    • decreased range of motion
Imaging
  • Radiographs 
    • usually unremarkable
  • MRI
    • usually unremarkable 
    • can show large hematoma 
Treatment
  • Nonoperative
    • rest, NSAIDS, steroid injections, and therapy
      • indications
        • main line of treatment
      • technique
        • medications
          • NSAIDs and muscle relaxants may be beneficial
        • therapy
          • focused on stretching the muscles about the iliac crest
          • place affected leg on maximum stretch
        • steroid injections
          • corticosteroid injection directed near iliac crest
        • return to play
          • additional padding during return to play
 

Please rate topic.

Average 3.5 of 32 Ratings

Thank you for rating! Please vote below and help us build the most advanced adaptive learning platform in medicine

The complexity of this topic is appropriate for?
How important is this topic for board examinations?
How important is this topic for clinical practice?
Questions (1)

You have 100% on this question.
Just skip this one for now.

(OBQ06.238) A professional hockey player is checked into the boards and develops a painful hip. He is point tender over the iliac crest. A clinical photo is shown in Figure A. What is the most likely diagnosis? Review Topic

QID: 249
FIGURES:
1

Hip flexor strain

3%

(74/2403)

2

Hip pointer

93%

(2232/2403)

3

Apophysitis

3%

(63/2403)

4

Piriformis syndrome

0%

(5/2403)

5

Trochanteric bursitis

1%

(23/2403)

L 1

Select Answer to see Preferred Response

SUBMIT RESPONSE 2
ARTICLES (1)
Topic COMMENTS (0)
Private Note