What is the diagnosis for a 68-year-old male with a history of atrial fibrillation (A. fib) on Eliquis (apixaban) presenting with right hip discomfort and expanding bruising after a fall 2 days prior, with initial mobility issues that have since improved, but now experiences stiffness?

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Differential Diagnosis for 68 year old male with history of A. fib on eliquis presenting with right hip discomfort

  • Single most likely diagnosis
    • Hematoma: Given the patient's history of anticoagulation with eliquis and the recent fall, a hematoma is the most likely diagnosis. The expanding bruising to the right hip supports this diagnosis.
  • Other Likely diagnoses
    • Soft tissue injury: The patient's fall and subsequent hip discomfort could also be due to a soft tissue injury, such as a strain or sprain.
    • Contusion: A contusion is also possible, given the patient's history of trauma and the presence of bruising.
    • Osteoarthritis flare: The patient's hip discomfort could be due to an osteoarthritis flare, especially if the patient has a history of osteoarthritis.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Hip fracture: Although the patient's mobility issues have improved, a hip fracture is a possibility that should not be missed, as it can be devastating if left untreated.
    • Internal bleeding: Given the patient's anticoagulation, internal bleeding is a possibility that should be considered, especially if the patient shows signs of hemodynamic instability.
    • Septic arthritis: Although less likely, septic arthritis is a serious condition that should be considered, especially if the patient has a fever or other signs of infection.
  • Rare diagnoses
    • Avascular necrosis: Although rare, avascular necrosis is a possibility, especially if the patient has a history of steroid use or other risk factors.
    • Bone tumor: A bone tumor is a rare possibility, but should be considered if the patient has a history of cancer or if the hip discomfort is persistent and unexplained.
    • Hemarthrosis: Hemarthrosis, or bleeding into the joint, is a rare possibility, but should be considered given the patient's anticoagulation and history of trauma.

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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