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Having Pain In Hip, Inner Thigh And Groin Area. CT Scan Normal. What Is Causing This Pain?

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Posted on Thu, 18 Oct 2012
Question: My daughter is 25 yo. 5 wks ago she had left side hip pain that radiated down her inner thigh and into her groin. An CT Scan revealed nothing. With in a week of that, the pain went to the right side as well with additional symptoms of sacroiliac pain and tenderness to the touch, muscle spasms in her upper thighs and under her buttocks, pain in the pubic bone area and inabiltity to walk due to pain. She is in excruiating pain and basically bedridden. Please any thoughts you might have on this?
Do you have any idea what is causing her pain and symptoms?
doctor
Answered by Dr. Rahul D Chaudhari (29 minutes later)
Hi,
Thanks for the query.
Hip pain going to the groin and front of thigh could be due to renal cause or disc herniation in upper lumbar level. I would need some more information in order to be able to help you better:
a. You said CT negative. What CT was done? CT abdomen? CT spine?
b. Does she have any significant past medical history?
c. Do you have the physician examination findings?Can she lie on a bed and lift her leg straight up?
d. Does she have any problems in urination like burning, having to go the bathroom frequently or bloody urine?
e. Does she have any tingling or numbness in legs?
f. Can she rotate her hip joint? Is it painful?
g. Does she have any problems with her menstrual cycles?

If she as no urinary or menstrual issues, then MRI of the hip/sacroiliac joint/lumbar spine will definitely help us to diagnose the condition.
Awaiting your response
Thanks.

Above answer was peer-reviewed by : Dr. Aparna Kohli
doctor
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Follow up: Dr. Rahul D Chaudhari (7 hours later)
a. You said CT with contrast abdomen, CT with contrast spine, CT with contrast hip, CT with contrast hip.
b. Hyperactive thyroid was diagnosed as part of the medical work up for her above problem
c. Do you have the physician examination findings? NO, but I am going to get copies of her medical records relating to above problem.
Can she lie on a bed and lift her leg straight up? NO
d. Does she have any problems in urination like burning, having to go the bathroom frequently or bloody urine? NO
e. Does she have any tingling or numbness in legs? NO, just pain from the thighs to the knees (bilateral).
f. Can she rotate her hip joint? Is it painful? NO, too painful. She can not walk at all because she can not move her legs because of the pain.
g. Does she have any problems with her menstrual cycles? YES. She doesn't have a monthly menstrual cycle, however Gynecologist was consulted, did an exam and testing and the findings were negative for anything gynecological. It has been determined the absent menstrual cycles are because of the thyroiditis.

Also, a gastroenterologist performed a colonscopy which was negative. An oncologist was consulted, a gallium test was performed and it too was negative for "disease" showing only inflammation and the oncologist ruled out cancer. An internist was consulted who said she couldn't find anything to explain the symptoms.

Initial CBC showed slightly elevated WBC (neutrophils) (14.4) and slightly elevated Platelets (503) which was lower (430) on a subsequent CBC. Her SED Rate was intially (96), but was lower on a subsequent test (86). She can not have an MRI as she has titanium rod (ISKD) in her femur and tibia due to a leg lengthing procedure for leg length descrepancy (the last surgery for this was Feb. 2008)
doctor
Answered by Dr. Rahul D Chaudhari (7 hours later)
Hi,

Thanks for the information.

This is new information to me that she underwent ISKD. Was it bilaterally done? What is the status of limb lengthening now? What’s the x-ray look like? The osteotomy site completely united? Do you have any X-rays of the femur? Any rod migration along the bone? I think the problem may be arising from the limb lengthening. We need to rule out any non union at the osteotomy site? Any rod migration? At times too much lengthening may overstretch muscles which can cause pain.

Please send me the x-rays of the both femur and hip joint. You have a feature to upload the reports / image by yourself at the right side of the query page, please utilize that so that I can answer your queries better.

Awaiting your response.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
Answered by
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Dr. Rahul D Chaudhari

Spine Surgeon

Practicing since :2002

Answered : 322 Questions

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Having Pain In Hip, Inner Thigh And Groin Area. CT Scan Normal. What Is Causing This Pain?

Hi,
Thanks for the query.
Hip pain going to the groin and front of thigh could be due to renal cause or disc herniation in upper lumbar level. I would need some more information in order to be able to help you better:
a. You said CT negative. What CT was done? CT abdomen? CT spine?
b. Does she have any significant past medical history?
c. Do you have the physician examination findings?Can she lie on a bed and lift her leg straight up?
d. Does she have any problems in urination like burning, having to go the bathroom frequently or bloody urine?
e. Does she have any tingling or numbness in legs?
f. Can she rotate her hip joint? Is it painful?
g. Does she have any problems with her menstrual cycles?

If she as no urinary or menstrual issues, then MRI of the hip/sacroiliac joint/lumbar spine will definitely help us to diagnose the condition.
Awaiting your response
Thanks.