Bilateral lateral hip pain

The patient is a very pleasant 67-year-old gentleman who is at the end of his carrier as a designer and fabricator. He is going to be retiring in the near future. He states that he has been treated at this office before and that his “hips are out of alignment.” He describes two-month history of pain emanating from the proximal lateral aspect of his hips down to halfway along the thigh. He states that the pain is present when rising from a deeply seated position and abates after several steps of ambulation. He has no change in his discomfort with stair ascending or descending and this pain has always gone when lying supine. He denies any history of groin pain, but states he does have a left inguinal hernia, which is due for surgical correction. He has not had any imaging or workup for any prior hip joint issues. He also presents today for me to look at his right knee where he has undergone prior partial meniscectomy (per patient).

ASSESSMENT:
This is a 67-year-old gentleman with two-month history of bilateral symmetrical lateral proximal lower extremity pain.

IMPRESSION:
Suspect referred pain from hip joint issues; refereed pain secondary to osteoarthritis versus labral tearing.

PLAN:
I think he should continue to move forward with treatment with Dr. his chiropractor. He has been told in the past that his “hips are out of alignment” and I do agree with this rudimentary diagnosis. I would like to obtain plain x-rays of the bilateral hips and we will do that.

With regards to his right knee, he does have medial compartment tenderness overlying the joint line without any erythema, ecchymosis or induration. He has good flexion and extension abilities, but he does have discomfort in the right knee when descending stairs today. I would like to obtain plain x-rays of the bilateral knees to assess for osteoarthritis whether or not there may be a more significant process ongoing there as he states he is post-meniscectomy in the past.

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