Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ Iliac crest contusionSubcutaneous contusion ++ 924.01 Contusion of hip ++ S70.00XA Contusion of unspecified hip, initial encounter ++ 4E: Impaired joint mobility, motor function, muscle performance, and range of motion associated with localized inflammation +++ Description ++ Direct trauma/blow to iliac crest causing immediate pain and debilitation1Acute pain and bruising (hematoma) along the iliac crest to the bone and surrounding muscles +++ Essentials of Diagnosis ++ Subcutaneous contusion, graded I to IIIAcute onset from initial trauma; direct blow to unprotected iliumInternal muscular bleeding and swelling can/will occur within minutes or hours of injuryPain radiating to the internal and external oblique musclesPossible parasthesia over anterolateral thigh +++ General Considerations ++ In younger children, concern must be on a slipped growth plateStress fractures or blood supply disruption to the hip may show up laterWearing of a hip pad in sports, to limit contusionCan lead to myositis ossificans2 +++ Demographics ++ Younger athletic population, direct hot from helmet or fallCan be seen in older adults secondary to a fall or car accident +++ Signs/Symptoms ++ Hematoma1Point tender with palpation over iliac crest and associated musclesCrepitus felt during palpationMuscle spasm notedPain with AROM hip flexion, hip abduction, trunk rotation, trunk flexionSwellingRednessEcchymosis, if caused by direct trauma +++ Functional Implications ++ Antalgic gaitPainful end ranges during ambulationDecreased weight bearing on the involved side with increased weight bearing on the unaffected extremityPain and weakness as ITB passes over greater trochanterPain limiting functional activities (i.e., ADLs, physical and athletic activities)Difficulty sleeping on affected side +++ Possible Contributing Causes ++ TraumaFall on sideBlood thinner medication, increases internal bleeding +++ Differential Diagnosis ++ Ilium fracture, other avulsion fractureIliotibial band syndromeAvascular necrosisSacral iliac dysfunctionGreater trochanteric bursitisLumbar radiculopathyTendinitis of gluteus medius, gluteus maximusSnapping hip syndromeSciaticaFemoral neck stress fractureLumbar disk herniationLumbar degenerative disc diseaseLumbar spinal stenosisHip arthritisSeptic arthritisMetastatic tumorInguinal and femoral herniaHip labral issuePiriformis syndromeMuscle strain (gluteus minimus, internal oblique, external oblique) +++ Imaging ++ Radiographs of iliumRadiographs of spine and hipMRI for soft tissue and/or for fractureBone scan for stress fracture and hip necrosisDiagnostic ultrasound +++ Medication ++ Corticosteroid injection4NSAIDs, acetaminophen ++ For imagingFor medicationsAnti-inflammatory or corticosteroid injection ++ Limited activity, especially with transition from hip flexion/extension (i.e., in/out of chair)Unable to sleep secondary to pain with lying on affected sidePainful ... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.