A 56-year old woman presents for evaluation of left hip pain. Several hours ago, she says, she was walking on a trail when she fell from an embankment. The 4-ft fall ended with her landing primarily on her left hip and elbow.
Afterward, she was able to ambulate with assistance but noticed increased pain in her left hip and groin with movement. The elbow discomfort resolved shortly after the incident. She denies numbness or tingling in her extremities and loss of bowel or bladder function.
Physical exam reveals a well-developed, well-nourished female without any extremity deformity or leg shortening. Palpation elicits left-sided groin pain, as well as left posterior hip and sacroiliac joint pain. Both active and passive range-of-motion of the hip elicit pain, but straight-leg raise does not. The patient can bear weight on the left leg with the assistance of a walker.
There is no laxity in the knee joint, and the ankle mortise is stable. There are no signs of swelling or bruising, and the skin is intact. Dorsalis pedis and posterior tibial pulses are 2+, and sensation in the left foot is intact.
Radiographs of the left hip and pelvis are obtained. What is your impression?
