Man with bilateral hip pain
Journal
Journal of the American College of Emergency Physicians open
Journal Volume
1
Journal Issue
4
Date Issued
2020-08
Author(s)
Chiu, Yu-Chen
Hsieh, Fu-Chien
Chu, Sheng-En
Sim, Shyh-Shyong
Sun, Jen-Tang
Abstract
A 20-year-old man with no systemic disease presented to the emergency department with bilateral hip pain after a traffic accident. Upon physical examination, the patient was afebrile, with a pulse rate of 128 and blood pressure of 121/79 mmHg. Point-of-care ultrasound was performed (Figure 1 and Video S1), and the diagnosis was confirmed with computed tomography (Figure 2). The retroperitoneal space is difficult to evaluate using ultrasound.1 However, in severely injured patients, discontinuity of the pelvic bone, mixed echogenic hematoma, or asymmetric thickness of the bilateral iliopsoas muscle may be present. In trauma patients with an unstable hemodynamic status, a pelvic floor ultrasound can be part of the focused abdominal sonography and detect fatal retroperitoneal hemorrhage, which requires immediate bleeding control.2 In this case, the patient was treated with right internal iliac artery transarterial embolization followed by external fixation of the pelvis. He was discharged 5 weeks later and rehabilitated at the outpatient clinic. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
Type
note