Differential Diagnosis for Gluteal Hip Pain in a 12yo Female Distance Runner
Single Most Likely Diagnosis
- Iliotibial (IT) Band Syndrome: This is a common overuse injury in runners, especially in females, causing pain and swelling on the outside of the hip and thigh. The rolling or slipping sensation can be attributed to the friction between the IT band and the lateral femoral condyle.
Other Likely Diagnoses
- Trochanteric Bursitis: Inflammation of the bursa over the greater trochanter can cause pain and tenderness in the gluteal area, exacerbated by running and activities that involve hip movement.
- Gluteus Medius Tendinopathy: This condition involves inflammation or degeneration of the gluteus medius tendon, leading to pain and weakness in the hip, particularly with activities like running that involve hip abduction.
- Piriformis Syndrome: Compression of the sciatic nerve by the piriformis muscle can cause pain, numbness, and tingling in the buttock and leg, which might be exacerbated by running and could be perceived as a rolling or slipping sensation.
Do Not Miss Diagnoses
- Slipped Capital Femoral Epiphysis (SCFE): A serious condition where the femoral head slips off the femoral neck, more common in adolescents. It presents with hip pain, especially with weight-bearing activities, and can lead to severe complications if not promptly treated.
- Stress Fracture: Overuse stress fractures in the hip or femur can cause significant pain and need to be identified early to prevent further injury.
- Osteonecrosis (Avascular Necrosis): Although rare, this condition involves the death of bone tissue due to a lack of blood supply and can be a complication of various conditions, including steroid use or severe trauma.
Rare Diagnoses
- Osteoid Osteoma: A benign bone tumor that can cause nocturnal pain and is typically relieved by NSAIDs. It's rare but should be considered if other diagnoses are ruled out.
- Inflammatory Arthropathies (e.g., Juvenile Idiopathic Arthritis): These conditions can cause hip pain and stiffness, among other symptoms, and are important to diagnose due to their potential for significant morbidity if left untreated.