Abstract
Clinicians must be aware of this rare but devastating diagnosis, as early diagnosis may improve prognosis. Case presentation: An 11-year-old African American female presented to a pediatric orthopedic clinic with a 6- month history of insidious onset left hip pain. Over 6-months her pain became more severe, and limited her ability to walk. The left hip was fixed in 40-degrees flexion, 20-degrees abduction, and 30-degrees of external rotation. New x-ray findings consistent with idiopathic juvenile chondrolysis of the hip were present. Discussion: First described in the early 1900s, chondrolysis of the hip was initially identified in patients following slipped capital femoral epiphysis. Later, patients with no clear etiology were diagnosed. Associations with trauma, burns, infection, and prolonged immobilization have also been described. The course is variable, with an acute phase lasting 6-16 months followed by a chronic stage of 3-5 years. Conclusion: Idiopathic chondrolysis of the hip is a challenging diagnosis with devastating complications. Ultimately, most patients experience a spontaneous resolution of pain, develop early arthritis, and often arthrodesis
Highlights
Juvenile Idiopathic Chondrolysis the hip is a devastating disease
Idiopathic chondrolysis of the hip is a challenging diagnosis with devastating complications
Most patients experience a spontaneous resolution of pain, develop early arthritis, and often arthrodesis
Summary
Idiopathic chondrolysis of the hip presents with an insidious, progressive onset of hip and groin pain. Patients will demonstrate the affected hip to be extended, adducted, and internally rotated [2] This contrasts to other hip pathology including fracture, infection and joint effusion, which typically are associated with the hip in an abducted and externally rotated position. Flexion contractures are more prevalent in cases of idiopathic chondrolysis as compared to patients with slipped capital femoral epiphysis [2]. Chondrolysis was identified in patients following slipped capital femoral epiphysis [1]. Treatment of chrondrolysis remains difficult, and few modalities provide adequate relief of pain for patients. Ambulation assistive devices such as crutches or a walker are often prescribed. Tenotomy, osteotomy, hip arthrodesis or early joint arthroplasty may be required [13-15]
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