FRACS Orthopaedic Exams
A seventeen-year-old girl was referred with a three-year history of progressive pain in the left groin. There was no history of trauma, and the medical history and family history were unremarkable. The pain was present on most days and increased when the patient performed weight-bearing activities. The patient was a very active lacrosse player, but she had been unable to play in recent months because of pain in the left hip.
The Impingement test, performed by positioning the hip and the knee in 90° of flexion while internally rotating the hip, elicited pain only in the left hip. The results of neurologic and vascular examination of the lower extremity were unremarkable.
The results of laboratory studies, including a complete blood count, measurement of the erythrocyte sedimentation rate, and measurement of the levels of C-reactive protein and rheumatoid factor, were negative.
The patient underwent open dislocation of the hip and débridement. A biopsy of the synovium was performed.
What is the diagnosis and how should this be treated?