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Suggest treatment for hip pain due to injury - Online Doctor Chats

Date : 23-Feb-2014
User rating for this question
Very Good Posted in: Bones, Muscles and Joints
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2408 Questions
User:I had a fall 11 days ago from about 3 feet, flat onto my back. I have a 6x3 hematoma of the gluteus XXXXXXX on the left. A pelvic CT scan on the day of the fall showed no acute bony abnormality of the pelvis. The ache in my hip is bad and I wonder if the initial pelvic CT would evaluate for any hip injury?

Should I have it re-imaged? Perhaps a hip x-ray, or would they have seen all injuries on the day of the fall?

Thank you
User:I am in great pain and I wonder if perhaps my hip is injured?
Doctor:I will answer your query, please let me read your question
User:Thank you
Doctor:If the CT scan on the day of injury did not show any fractures then you can be sure that you do not have any fractures
Doctor:hematomas can be very painfull
User:Okay so the ache is anticipated
User:what about an occult hip fracture? possible or no?
Doctor:particularly large hematomas such as yours willbe very painful
Doctor:CT scans can pick up the minutest of bony abnormalities
Doctor:so do not worry
Doctor:Are you able to bear weight on the painful side?
User:if the radiologist looked at my pelvis would he have looked at the hips also? i had lumbrosacral and pelvic CT in emergency
User:yes i can stand for short periods the ache only goes away if i lie down
Doctor:Pelvis CT scan is not complete without hips
User:okay so they would have seen any injury and now its just healing
Doctor:so, yes the radiologist would have looked at the hips as well
Doctor:The pain is due to the hematoma
User:The hematoma is like a baseball will that take a long time? I am black and blue all across my buttocks
User:The CT report says
Doctor:and yes it is healing
Doctor:as soon as the blood gets absorbed you will be better
User:there is a 6.7 x 2.7 presumed soft tissue hematomoa within the left gluteus subq fat with extensive surrounding stranding
Doctor:It will take about 20 to 30 days for complete resorptions
User:Wow I cannot sit yet
Doctor:Apply heat to speed up the hematoma resorption
User:any risk of blood clots from this type of injury?
Doctor:And if it is causing you too much pain, you can get the blood removed by a fine needle aspiration
Doctor:No, this will not cause any blood clots
User:Oh okay so if it does not go away it can be fixed.
Doctor:Yes, it can be fixed easily
Doctor:The blood just needs to be sucked out with a syringe and long needle
User:Oh good that is reassuring thank you. I wondered if I should have more images but it seems like that is unnecessary. At what point would you consider that if the pain does not get better? or would you?
Doctor:If the pain does not get better after 15 days then you should get looked at again
Doctor:and get the blood removed
Doctor:You can also take some pain killers such as motrin
User:Okay today is day 11 and the painis about a 6/10 at the moment. The ER doc gave me Percocet but it makes me vomit so i have not been taking it. Also prescribed Voltaren and i havent tried that but maybe i should.
Doctor:Take Volteran
Doctor:that is a good painkiller
User:Okay i will fill the prescription today I just dont like taking pills that make me sick but perhaps it will not
Doctor:You should feel much better once you start taking the medicines
Doctor:Take the painkillers after food
User:Are there any things I should be avoiding at this point? in terms of activity
Doctor:that will reduce the gastric irritation
Doctor:you can be active and do everything
Doctor:there are no restrictions
User:I have not tried driving because the pain is bad when I sit but if i put any pressure on the hematoma is there any risk?
User:this may sound goofy but can it rupture?
Doctor:No, gluteal muscles are quite big, and they can bear your weight
Doctor:only problem will be the pain
Doctor:if you sit, then you will have severe pain
User:yes the pain is intense when i try and sit. I have to stand or lie on my side. I will wait until next week and if it is not significantly improved i guess i will have to see the doc again.
Doctor:you have the hematoma because of the rupture of muscles, sitting will spread the blood evenly, it will not cause any more damage
Doctor:Yes, you are right
User:I feel better though knowing they would have seen any breaks
Doctor:I can understand your condition and I know how painful the hematomas can be
Doctor:Yes, if at all you had any breaks they would have picked it up
User:Okay well i don't have anymore questions at this point. The timer says 10 minutes left. not sure if it matters
Doctor:It does not matter
Doctor:If you don't have any question, you can happily close the chat window
Doctor:Thank you very much for using the chat option
Doctor:It was my pleasure assisting you with your query.
User:Thank you
Doctor:Have a good day
Doctor:take care
User:You too
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