Octogenarian hip pain

December 4, 2011 7:56 AM

What is wrong with my octogenarian mother's hip? She cannot get out of bed without excruciating pain.

Just wanted to run this by the hive before I head over there to see if it's possible to derive if a trip to the emergency room is warranted or maybe she should just wait until tomorrow to visit a doctor or chiropractor.

She said the pain started in her right hip on Friday morning but felt ok as the day wore on to the point she felt fine going out to dinner. On Saturday she couldn't put any pressure on it and was stuck in bed all day and it's the same today, no worse and no better.

The pain is in her right hip where the hip bone meets the femur, it doesn't hurt when she presses on it and she can still move it around lying in bed but when she tries to stand on it the pain shoots from the hip to the knee and she cannot lift the leg without great pain. She had broken the tibia of this leg about 4 years ago so she's been favoring it ever since also the doctor told her that hip was arthritic about a year ago. Just wondering if this is some kind of alignment/muscle/nerve issue that might benefit from a chiropractor visit or if it's more likely to be a structural issue. What makes me think that it's not a bone/cartilage issue is that it came about suddenly, everything I've read only about that says it's a gradual deterioration.

posted by any major dude to Health & Fitness (5 answers total)

Best answer: IANAD. Call your mother's primary care physician if you can and see what he or she says. If you can't reach that person or another physician in her physician's practice, you should consider visiting an urgent care clinic. There are some types of bone injury that don't immediately or consistently impair motion but nonetheless should be attended to as soon as possible, particularly in older women who are predisposed to have a difficult time healing fractures Given that she's been bedridden for a day already, if you strike out on the physician and an urgent care clinic, please head to the ER. Mobility wanes fast in old age.
posted by Inspector.Gadget at 8:03 AM on December 4, 2011

Best answer: I would take her in to rule out pathologic hip fracture, especially since she is non-weight bearing. At her age, an inability to bear weight, combined with pain in the area you describe makes fracture an automatic part of the differential. There is a misconception that hip fractures result only from falls--fracture or subluxation can easily occur from doing normal activities, especially at the head of the femur. Further, it isn't unusual to see elderly folks have a certain amount of range of motion or activities after these kinds of fractures. However, it is still serious, especially in regards to the blood supply to the head of the femur and hip socket, as well as aggravating a potentially serious injury.

Good luck--I'll be thinking about you guys.
posted by rumposinc at 8:05 AM on December 4, 2011 [3 favorites]

Response by poster: thanks guys, she's on her way.
posted by any major dude at 8:42 AM on December 4, 2011 [3 favorites]

It's pretty much impossible for a doctor to diagnose "hip" problems without laying hands on the patient. The first important clue is where the patient points. If she points to the front of the hip, that usually means the problem is in the hip joint where the ball of the femur meets the acetabulum of the pelvis (there is no "hip bone"). With a sudden onset of severe pain, I would think fracture of the femoral neck or avascular necrosis.

If she points to the side, it's usually bursitis. Bursitis typically has a very gradual onset (days to weeks) and is not disabling.

If she points to the buttock, the problem is usually in the spine.
posted by neuron at 2:21 PM on December 4, 2011

Response by poster: just want to give a followup on this. She went to the hospital, got a bunch of x-rays and the doctor found there was nothing broken. He gave her a percocet and sent her home. She called her doctor on monday who gave her a prescription for Tylenol with codeine and got her an appt with an orthopedic surgeon. She is still in great pain and cannot walk. The orthopedic surgeon took more x-rays says that he thinks it may be sciatica and is now referring her to a spinal specialist on Friday to perform an MRI...
posted by any major dude at 7:39 PM on December 7, 2011