Abstract
The aim of this report is to describe a diagnostic protocol that can differentiate enthesopathy from referred pain of the hip or spinal origin.
Enthesopathy at the pelvic insertion of rectus femoris was causative in 4 patients: a man aged 92 years, and three women aged 67, 71 and 89 years. They had a past history of spinal disorders, and weight loss in a short period, and marked degenerative changes in spine or hip on diagnostic imaging.
Initially, we considered hip or spinal disorders. Subsequently, we developed a diagnostic provisional protocol that includes characteristics of pain, provocation tests, and knee extension against resistance, which can be corroborated by analgesic blocking with steroid.
The clinical usefulness in the diagnosis and treatment of the lesion is described. Such lesions may not be rarely encountered in an aging population, and it should be differentiated from referred pain of hip or spine.
