Summary An illiac crest contusion (hip pointer) is a traumatic hematoma overlying the iliac wing that occurs due to direct trauma or crushing injury, most commonly during contact sports. Diagnosis is made clinically with tenderness over the iliac crest with extensive contusion and hematoma near iliac crest. Treatment is nonoperative with NSAIDs, rest and stretching. Etiology 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
QUESTIONS 1 of 1 1 Previous Next (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? QID: 249 FIGURES: A Type & Select Correct Answer 1 Hip flexor strain 3% (107/3328) 2 Hip pointer 91% (3042/3328) 3 Apophysitis 4% (117/3328) 4 Piriformis syndrome 0% (13/3328) 5 Trochanteric bursitis 1% (39/3328) L 1 Question Complexity C Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 2 Review Tested Concept Review Full Topic