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Hip Pointer I Pathology A hip pointer refers to a direct contact injury to the iliac crest of the pelvis The iliac crest is commonly known as the hip bone The term hip pointer is somewhat confusing It can refer to a deep bruise of the muscle and bone a small chip fracture or even a complete break Typically however this term refers to a severe bruise and not a fracture II Mechanism Hip pointers are caused by a direct blow to the side of the hip and pelvis They are most commonly associated with football but can be seen in almost any contact sport Spearing the hippelvis with a helmet while tackling may be the most common cause Hip pointers also occur frequently in volleyball where athlete constantly hits the floor while diving for a ball III Signs and Symptoms Hip pointers present with a history of a contact injury in the area Pain and tenderness along the crest of pelvis is also seen The patient may walk with a limp and have difficulty moving the hip away from the body against resistance Swelling and ecchymosis will be noticeable Trunk flexion and rotation will be painful Possible discoloration may be visible IV EvaluationSpecial Tests Palpation around the area will be extremely painful Single-leg weight bearing may also be painful on the side of the injury X-rays are taken to rule out fractures Occasionally further studies may be indicated if the patients symptoms do not improve with treatment V Initial Care Initial treatment consists of icing compression and rest Anti-inflammatory medication and gentle stretching should begin at about 48 hours after the injury A personalized program of strengthening flexibility and coordination exercises is then designed for the patient If the bruising of the muscle and bone from the injury is severe however return to full activity may take several weeks Padding to the area can protect the area
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