Lymphoma as a Mimicker of Femoroacetabular Impingement: A Case Report.

Abstract

Femoroacetabular impingement (FAI) is an increasingly recognized source of hip pain in the young athletic patient population1. As awareness regarding the presentation and physical examination findings consistent with this diagnosis grows, an increase in the incidence of its diagnosis is likely to occur. Most patients present with anterior hip or groin pain that is exacerbated with activities that promote flexion, internal rotation, and/or adduction of the involved hip. Patients will often have difficulty getting into and out of a vehicle and putting on socks and shoes, and they also experience pain with prolonged sitting2. There is a wide variety of possible diagnoses in patients presenting with vague anterior hip or groin pain, including osteoarthritis, sports hernia, femoral neck stress fracture, pubalgia, and malignancy. Osseous lesions, including myeloma and lymphoma, can often be the first presentation of a malignant disease process; however, such presentations are more often associated with vague groin pain and concomitant constitutional symptoms. Currently, to the best of our knowledge, there are no reports in the English-language literature describing an initial presentation of lymphoma with symptoms and radiographic findings consistent with FAI. Additionally, while there are characteristic radiographic and magnetic resonance imaging (MRI) findings associated with FAI, bone marrow signal abnormalities are atypical, and there are no reports describing hematologic abnormalities in the setting of FAI. We describe a unique presentation of right hip pain consistent with FAI in a patient ultimately found to have non-Hodgkin lymphoma. The patient was informed that data concerning the case would be submitted for publication, and he provided consent. A previously healthy fifty-six-year-old man initially presented with a three-month history of right hip pain. He denied …