Hip osteoarthritis in this 35 year old male

In this video review of a young man’s lumbar x-rays, Dr. Castanet will explain that the chief complaint was low back pain, and he certainly has that, but given that his hip pathology is so severe, and his gait is so affected, it is either contributing to, or largely causal, in his low back pain. So it is important to evaluate his hip, figure out its contribution to his back pain, and find him definitive treatment for his predominant problem.

If this young man’s worst problem is his hip, and I treat his back, instead, it may be a waste of his time and money, because it might not be possible to resolve his low back for any appreciable length of time, without restoring his normal gait pattern.

I did not have x-rays of his hip yet, but I did get his lumbar x-rays, and, as is often the case, I can see his hip joints somewhat on these x-rays, and he seems to have visible, severe hip degeneration on his x-rays. It turns out that I saw this young man about two years ago, for the same problem, and he has not yet been able to get hip surgery. But he is going to pursue that now that he has insurance. In the meantime, he wanted to see me again because the previous time I treated him low back pain, he did get some worthwhile relief. So I’m treating him again today, hoping he’ll get some relief until he can get his hip replaced.

Hip osteoarthritis in this 35 year old male

In the real world of patients and doctors, sometimes you do the best you can. And in this case, I give him some relief until he can do what he needs to do. My job is to honestly tell him the facts, and let him make whatever choice he wishes for palliative care until he resolves what I have told him is his problem.

If I can help you with your neck or back pain, please call me at 404-558-4015.