0:00

This, I thought was a very interesting case.

0:03

This is hip pain for one day after being tackled in a football game.

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And, uh, going right to the saline findings, we see that, uh, this, uh,

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posterior ace tablum is, uh, basically, uh, fractured along with, uh,

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the, uh, posterior, uh, uh,

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acetabular labum as well as the, uh,

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capsule ligament and structures here posterior. We also see some, uh,

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mild to moderate amount of, uh, surrounding soft tissue and muscle edema.

0:34

Okay. Uh, centered in the region of the obterator internist, uh,

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muscle and tendon right here,

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as we can see right there as it goes to attach upon the medial aspect of the,

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uh, uh, greater tro cantor. Okay.

0:49

And here to, okay. Uh,

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we can see another, uh, we have another shot in the coronal view,

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uh, of this, uh, non-displaced, minimally displaced, uh,

1:03

posterior, uh, acetabular wall fracture, presumably related to a transient,

1:08

uh, a hip subluxation or dislocation event. And, and interestingly,

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this, uh, for those that are interested,

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I think this was originally or one of the seminal papers,

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papers was written by, um, Dr. Hollis Potter in, in, uh,

1:24

JBJS, uh, a few years back. And if you, uh,

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watch, uh, replays of, uh, especially American football games, uh,

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some of these athletes, uh, I, I believe, uh, for instance,

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if, uh, for those that follow American football, um, uh, Bo Jackson,

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a very famous football, uh, NFL football player, uh, uh,

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football who, who, who used to play for the, uh,

1:51

Oakland or the Los Angeles Raiders, uh,

1:55

some believe had this injury where they, he, uh,

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during a tackle during the game, he, he, um,

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hyper extended his, his, um,

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his hip and his leg was still able to run with the

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tackler hanging onto his leg. And, uh,

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some believed that he dislocated or translate subluxated and had this

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sort of injury and later went on to, uh, osteonecrosis of the femoral head.

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Um, so this is, uh, uh, before, uh, Dr.

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Potter's article in, in JBJS, I believe it was. Um,

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and we can, uh, try to look for that article and forward that to y'all, um, uh,

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for you guys to glance at, at your leisure. But, uh, an an often unrecognized,

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uh, but serious injury as you can imagine, that can lead to, uh, not,

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obviously not only instability of the hip, but gradual or,

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or premature secondary osteoporosis.

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So something to certainly think about. Um, and, uh, you

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May not, uh, see it,

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or it may not be obvious because the hip often relocates at the time of

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injury. So you wanna be,

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be mindful and pay attention to these secondary signs. A colleague of mine, uh,

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uh, I believe Dr. Hames in s Skull Radiology, along with, uh,

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some of his trainees, uh,

3:19

put out an article of some of these secondary findings of, uh, of,

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uh, uh, hip di hip dislocation.

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So I also highly recommend that article. Um, I forget the first author.

3:32

I apologized, but that was certainly in, uh, definitely in, uh,

3:35

skeletal radiology, some of those findings there.

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So really a nice case of, uh, uh, transient, uh,

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assuming transient, uh, hip, uh,

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posteriorly directed hip subluxation or dislocation with resultant, uh, uh,

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uh, fracture and, uh, uh, labral pathology. Uh,

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best obviously seen on this, uh, axial o bleak sequence.