Diagnosis

HIP POINTER


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 Definition A hip pointer refers to a direct contact injury to the iliac crest of the pelvis. The iliac crest is commonly known as the "hip bone", a misnomer.

Picture of Pelvis with Iliac Crest Highlighted
Details The term hip pointer is somewhat confusing. It can refer to a deep bruise of the muscle and bone, a small chip fracture or even a complete break. Typically, however, this term refers to a severe bruise and not a fracture.
Causes Hip pointers are caused by a direct blow to the side of the hip and pelvis. They are most commonly associated with football but can be seen in almost any contact sport. Spearing the hip/pelvis with a helmet while tackling may be the most common cause.
Diagnosis Hip pointers present with a history of a contact injury in the area. Pain and tenderness along the crest of pelvis is also seen. The patient may walk with a limp and have difficulty moving the hip away from the body against resistance. X-rays are taken to rule out fractures. Occasionally, further studies may be indicated if the patient's symptoms do not improve with treatment.
Treatment Non operative: Initial treatment consists of icing, compression and rest. Anti-inflammatory medication and gentle stretching should begin at about 48 hours after the injury. A personalized program of strengthening, flexibility and coordination exercises is then designed for the patient. If the bruising of the muscle and bone from the injury is severe, however, return to full activity may take several weeks.

Operative:
Surgery is very rarely indicated. It is usually reserved for patients with significant displacement of fractures of bone where the muscles attach around the pelvis.
Prevention

Maintaining excellent flexibility, strength and endurance of the hip, pelvis and lower back muscles may prevent some hip pointers. Most, however, are the unfortunate result of significant contact and are not preventable.


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