Left trochanteric bursitis

The patient was last seen in this office in July 9, 2012 for evaluation of pain in the left hip and buttock area. She was walking on a deck of a pool when she stepped down into the pool and slipped onto her left leg in a twisting motion and landing on her left hip and knee. She has been having a lot of pain in her left hip area over the femoral neck and greater trochanter. She has been using naproxen which provides her with temporarily relief of the pain. Physical therapy has also helped decrease the pain in the knee, but the pain is still severe enough to interfere with her enjoyment of life and activities of daily living.

DIAGNOSES:
1. 719.45 Hip joint pain.
2. Left trochanteric bursitis.

RECOMMENDATIONS:
I discussed with the patient the treatment options which included continuation of the physical therapy, the use of non-steroidal anti-inflammatories, and a performance of a steroid injection the left trochanteric bursa under ultrasound guidance. Questions were answered. I discussed with her the risks, benefits, alternative, and technical aspects of the procedure. The patient will have the procedure done.

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