0:00

So in this case, we have a person

0:02

with a traumatic right hip pain and fever.

0:05

Given that history though,

0:07

we still wanna apply our checklist approach.

0:10

And so now looking at the frontal radiograph, we can see

0:14

that the transverse processes, the L five are intact.

0:18

Iliac wings are maintained, SI joints are not widened.

0:22

In this person, we can see the arcuate lines

0:25

of the sacrum quite well.

0:28

The ileal and ileal issue line is maintained on the left

0:33

and the right confluent here

0:35

with the tear drop on both sides.

0:37

This person does have some joint space narrowing, a bit

0:41

of subc chondral sclerosis

0:43

and acetabular osteophytes, maybe even a subc chondral cyst.

0:47

So there's some moderate osteoarthritis

0:49

involving those hip joints.

0:51

Pubic synthesis is not diastasis

0:54

and the femoral head neck contour is maintained bilaterally.

0:59

We now have our roc caners.

1:02

We see that both of 'em are intact.

1:04

They have a little bit of za fights here.

1:07

We'll notice that this person also has

1:09

multiple small other enthesophytes around their pelvis.

1:14

And so when you have that proliferation of bone,

1:17

that puts you in in a, uh, spectrum of what's known as dish

1:20

or diffuse idiopathic skeletal hyperos posis.

1:23

So that's a person that's a bit of a bone former

1:26

at their uh, tendon attachments.

1:29

But that's typically an incidental condition.

1:32

But in addition, now we see that there is an asymmetry

1:36

as we're looking at the proximal femurs, this area

1:40

of opacity that's seen in that subtrochanteric region.

1:46

We look at our frog leg projection. It's hard to see.

1:50

Looks like it's, some of it is projecting here posteriorly.

1:54

And so in this person, the diagnosis that we would make is

1:58

that there is moderate bilateral hip osteoarthritis.

2:01

But given the symptoms of a traumatic pain

2:05

and fever on the right, we would state

2:07

that there's findings compatible with

2:09

calcific tendonitis of the right hip.

2:12

This is near the gluteus maximus attachment

2:16

to that part of the femur.

2:18

And then there's underlying features of dish

2:21

or diffuse idiopathic skeletal hypers, ptosis.

Case: Calcific Tendinitis

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