Clinical Case Abstract
Pelvic injury – Rollerblading
Andrew D. Barclay, LECOM Sports Medicine, Erie, PA
Email: [email protected]
(Sponsor: Patrick F. Leary, FACSM)
HISTORY: A 60 year old female presented on a Friday afternoon with right groin pain for one week. Onset of pain after a fall while rollerblading. She was unable to bear weight on her right leg after the injury and during the evaluation. After examination, she was sent for radiographs of the pelvis and bilateral hips.
PHYSICAL EXAMINATION: Examination in the office of the right pelvis and hip revealed inability to flex the hip in supine position due to pain. Special testing revealed a negative log roll and FABER test, but positive FADIR test. Gait posture was antalgic and the patient was unable to fully bear weight on right leg.
DIFFERENTIAL DIAGNOSIS:
1.Hip/pelvic fracture
2.Hip dislocation
3.Hip osteoarthritis
4.Bone contusion
TEST AND RESULTS:
X-ray Pelvis and Bilateral Hips:
-nondisplaced fractures right superior and inferior pubic rami
-mild osteopenia
Pelvic CT:
-minimally displaced comminuted fracture right inferior pubic ramus
-nondisplaced fracture proximal right superior pubic ramus adjacent to the acetabulum
Dexa Scan:
-T-score of -2.1
Labs:
-Vit D pending
FINAL/WORKING DIAGNOSIS:
-Pelvic ring fracture
-Osteopenia
TREATMENT AND OUTCOMES:
1.Crutches until pain free
2.Ice and electrical stimulation
3.Vitamin D3 supplementation
4.Physical therapy started 3 weeks post injury
5.Progressed through a gradual return to activity
