Hip Pain

Name: Ellie Smith

Age: 78 years old

Date of Birth: 25th September 1946

Location: Emergency Department

Occupation: Retired Teacher

"My left hip has been giving me trouble for the last 6 months and seems to be getting worse."

• Site: Left hip

• Onset: Started about 4 months ago

• Character: Not sure how to describe it but it's a constant pain. Joints feel a bit stiff as well.

• Radiation: No

• Assoc Sx: Knee was a bit stiff last weekend but that was after 2 hours of gardening so you doubt it's related

• Timing: You think it's worse at the start of the day and eases off as you get moving

• Exacerbating Factors: Nothing really, but it's worse first thing in the morning

• Relieving Factors: Weirdly enough it goes away when you start working

• Pain Scale: Maybe a 6/10 in the morning but the stiff ness is worse

• Came on suddenly one day, nothing I can remember brought it on. Its gotten worse since. I've tried paracetamol and applying some brufen gel which did not help much

• Recent illness: None.

• Recent trauma: None. 

• Recent travel: None.

• Previous episodes: Never experienced this before.

• Ideas: "Is it just old age?"

• Expectations: "Could I get something stronger for the pain?"

• Concerns: “It can get quite painful. Could it be something more serious?"

• Bowel habits: Nil

• Urinary habits: Nil

• Appetite: Same as usual.

• Sleep: Same as usual

• Weight: No change 

• Pain in the chest/abdomen: None

• Headaches: None

• Fever: None

• Cardiology: Normal

• Respiratory: Normal

• Upper limb neurology: Normal, no numbness or tingling.

• Lower limb neurology: Just the pain in the hip, the leg might be weaker because of the pain as well

Previous hospital admissions: Just when I delivered my children

Previous surgeries: 1x Caesarean

Medical conditions:

• I have hypertension, but I take my medications and is usually very well controlled.

Medications:

• Paracetamol and ibuprofen gel

Allergies:

• None.

None

• Smoking: Never smoked

• Alcohol: Couple glasses of wine on the weekend

• Recreational drugs: Never

• Diet: I usually do the cookiny myself

• Exercise: I try to go for walks everyday with my husband

• Ill contacts: No one around me was recently ill

• Home: Lives with husband in a two storey flat, main carer for husband with dementia

• Active Daily Living: Independent with all ADLs , up until recently. Now really struggles with even basic household chores and unable to care for husband.

• Home Situation: Barely managing to get up and down the stairs. Worries will not be able to care for husband, not keen on care home for him.

• Question for student: Do you think it will get worse? I will need to make preparations for my husband and maybe think of moving into a smaller flat.

• Occupation: Retired school teacher