Subjective history
The patient completed self-reported questionnaires, namely the
international Hip Outcome Tool (iHOT-33) [28], the EuroQol 5
dimensions (EQ-5D-5L) [29] and numerical pain rating scale (NPRS)
[30] as displayed in Table I . She described right hip pain
with a 9-month history, in a ‘C-sign distribution’ (groin, lateral hip
and buttock) [31]. Pain was reported at night and affected all
activities, including sitting and standing (both limited to 20 minutes)
which affected her being able to work in her office job. Yoga used to be
her favourite form of exercise as she could adopt the positions easily,
but that was also now painful. She tried physiotherapy locally for the
last 8 months, but the exercises caused her hip pain to flare up, so she
stopped doing any exercise. Physiotherapy exercises previously
prescribed had aimed to improve gluteal strength [32].
In addition to her DDH, she reported endometriosis, polycystic ovaries,
hay fever, irritable bowel syndrome, heartburn, reflux, depression and
chronic fatigue. Medications taken were Codeine for pain relief 15mg
once a day, paracetamol 200mg, 2-3 times a day, Duloxetine 60mg once a
day, and Provera 25mg once a day.