Sorry I didnt see the attachment to this mail earlier.

Hello and thanks for asking the question.

A long standing hip pain can only mean there is an arthritic process in action. It could be osteoarthritis, rheumatoid arthritis, gout or avascular necrosis of head of femur.

I had a look at the soft copies of hip MRI you sent.

I'm sorry but those are inconclusive. I need to see a plain Xray first.

But provisionally I dont see a fracture or gross deformity per se. To reach a diagnosis I need you to answer the following questions-

1. Do you remember any event that gave rise to pain 3 years back like trauma, fall, fever, prolonged use of medicines etc?
2. Do you have any other medical history for which you are on steroids?
3. Are you addicted to smoking and drinking? If yes kindly tell the quantity.
4. Your weight and height.
5. When you say limited motion of hip, how much in degrees?(with straight legs in sleeping position as 0 deg for reference).
6. Do you notice any shortening of the affected limb?
7. And lastly what exact physiotherapy has been given and any medicines that you are currently taking.

Kindly send the report of the MRI slides you sent.

Hope i have answered your query.I will be available for follow up.

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Dear XXXXXXX
Thanks for replying.
I saw the Xrays and feel extremely satisfied with its excellent view
and quality.

In my opinion, there is no abnormality in the bones (head of Femur
and Acetabulum that form the hip joint). By which I mean there is no
deformity in relation to avascular necrosis or any occult arthritis,
nor there is any abnormal swelling in or around the joint.

Now the possibility of pain to arise from a thinning cartilage is
strong. That is difficult to catch on xrays but its existence can not
be denied, considering their is no other abnormality. The other
possible reason for pain could be a chronic stretch of the capsule/
ligament/ tendon/ nerve due to gymnastic splits you did over a period
of time.

Try to procure the MRI report for more intricate details. The medicine
you are taking is purely a pain killer. What you need is an anti
inflammatory drug (under your physicians supervision) for a short
period along with rest and support for few days. A traction of 4-5 kgs
to affected leg can also help in relieving symptoms. Discontinue any
sporting/gymnastic/recreational activity for a few weeks including
walking long distances and running/ climbing. Always keep the affected
leg straight and rested.

Remember, MRI is the gold standard investigation for picking up the
smallest of abnormality at the earliest stage! So kindly share with us
the report as soon as you get it for further evaluation.
Wish you an early recovery.
Good luck

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