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ABSTRACT PRESENTATION 

 

64 
Copyright © by Indiana State University                                                                                Clinical Practice in Athletic Training  
All rights reserved. ISSN Online 2577-8188                                                                        Volume 4 – Issue 1 – February 2021 
 

The Presentation of Adhesive Capsulitis of the Hip: A Case Study 
Patrick E. Jurewicz, MS, SCAT, ATC*; Ryan C. Berlinrut, PA-C†; Frank K. Noojin III, MD†; Zachary K. 
Winkelmann, PhD, SCAT, ATC* 
*University of South Carolina, Colombia, SC; †Prisma Health Orthopedics, Lexington, SC 
 

 
 
Full Citation 
Jurewicz PE, Berlinrut RC, Noojin FK, Winkelmann ZK. 
The Presentation of Adhesive Capsulitis of the Hip: A 
Case Study. Clin Pract Athl Train. 2021;4(1): 64-65. 
https://doi.org/10.31622/2021/0004.1.10.     
 
Presented at the 4rd Annual Athletic Trainers in the 
Physician Practice Society Meeting and Conference, 
February 26-27, 2021.  
  

ABSTRACT 

A 47-year-old female patient employed as a 
nurse in a mental health facility working 10-hour 
shifts reported to the sports medicine clinic for an 
initial orthopaedic examination after she twisted 
and fell out of bed causing direct compressive 
forces on her right hip. She has a history of an 
underdeveloped right hip, a non-steroidal anti-
inflammatory drug (NSAID) allergy, and low back 
pain (Oswestry score: 41/50, NPRS: 8/10) and is 
classified as a heavy smoker for 30 years.  
 
After initial onset, the patient’s pain increased with 
all motions. The patient also described a ‘catching 
sensation’ in her hip. The patient used crutches for 
one month until her pain was intolerable, and she 
began to utilize a wheelchair to ambulate for 
daily activities.  The differential diagnoses 
included acetabular labrum tear and ASIS 
tendonitis with additional considerations given to 
iliac spine avulsion fracture and lumbar 
radiculopathy. The initial examination included x-
ray which showed no abnormalities and a 
magnetic resonance imaging scan which identified 
ASIS tendonitis with a possible symptomatic 
acetabular labrum tear. The patient’s last full day 
of work was December 31st, 2019.  
 
Due to past medical history, the traditional 
management of NSAID use was ruled out and this 

patient was prescribed other pain medications. In 
addition, other interventions included an 
ultrasound guided intra-articular corticosteroid 
injection (CSI) and physical therapy with no 
positive response from the patient, however, minor 
relief was noted with oral steroid use. Pre-
operative blood work showed elevated levels of 
inflammatory markers, prompting a rheumatology 
referral. Patient reported feelings of anxiety, 
emotional stress, and depression on her health 
history questionnaire after three months of pain. 
The sports medicine clinic healthcare team 
ordered surgery of the acetabular labrum tear, 
which was delayed for five months due to the 
COVID-19 pandemic. 
 
The patient’s increasing pain and decreased 
ambulatory status forced her to remain out of 
work for the totality of the case presentation 
which spanned 8 months.  Finally, in August 2020, 
an arthroscopy of her right hip was completed 
which confirmed a final diagnosis of an 
acetabular labrum tear and adhesive capsulitis of 
the right hip (ACH). Post-surgery, the patient 
reported that her pain is improving and that she 
can ambulate using crutches. 
 
Adhesive capsulitis of the hip (ACH) is an 
extremely rare clinical diagnosis with very little 
literature written on the topic. Currently there are 
no specific special tests for the identification of 
ACH. However, ACH can present with similar 
indications as adhesive capsulitis of the shoulder 
such as chronic onset, decreased and painful 
ranges of motion, and synovial inflammation. Due 
to the uncommon nature of this ailment, traditional 
differential diagnoses are ruled out prior to 
consideration of ACH using diagnostic imaging. 
Traditional management of ACH includes oral 
anti-inflammatories, CSI, and physical therapy. 

https://doi.org/10.31622/2021/0004.1.10


The Presentation of Adhesive Capsulitis of the Hip: A Case Study 
 

 

65 
Copyright © by Indiana State University                                                                                Clinical Practice in Athletic Training  
All rights reserved. ISSN Online 2577-8188                                                                        Volume 4 – Issue 1 – February 2021  

Once other pathologies are ruled out, arthroscopy 
can be performed to confirm the presence of ACH 
which is similar to this case presentation. Providers 
should consider ACH when a patient presents with 
hip pain that is non-specific in terms of mechanism 
of injury, inflammatory markers, and pain 
location.  
 
 
Correspondence 
Patrick E Jurewicz, University of South Carolina, 1300 Wheat 
St, Columbia, SC 29208 
Email:  jurewicp@email.sc.edu  
 
 

mailto:jurewicp@email.sc.edu

