Approach to the Critical Patient

Alarm features requiring immediate evaluation

Cannot-miss diagnoses to exclude first

Initial triage priorities

Functional assessment at triage

Consultation triggers

Escalation and referral indications

History

Symptom characterization

Location and radiation

Aggravating factors and onset

Positional and activity-related triggers

Onset pattern

Risk factors

Patient-level risk factors

Important negative history

Differentiating historical features

Past medical and surgical history

Relevant prior history

Physical Exam

Vital signs and weight-bearing assessment

Baseline functional status

Palpation

Point tenderness assessment

Provocative maneuvers

Hip function testing

Differentiating findings

Negative findings that narrow the differential

PITFALLS

Common diagnostic errors

Differential Diagnosis

Life-threatening diagnoses

Cannot-miss conditions

Musculoskeletal mimics

Regional soft tissue pathology

Neurologic mimics

Referred and radicular pain

Intra-articular pathology

Hip joint disease

Laboratory Tests

Routine laboratory evaluation

Standard presentation

Infection workup

When septic bursitis or arthritis is suspected

Inflammatory arthropathy workup

When inflammatory joint disease is considered

Avascular necrosis and metabolic workup

When AVN or metabolic cause is suspected

Diagnostic Tests

Scoring Systems

Clinical diagnostic criteria for GTPS

MRI

MRI of the hip and pelvis

CT

CT of the hip and pelvis

Ultrasound

Musculoskeletal ultrasound

Disposition

Discharge criteria

Standard outpatient disposition

Admission indications

Criteria requiring inpatient management

Follow-up and referral

Outpatient follow-up plan

Prognosis

Expected clinical course

Treatment

Conservative first-line therapy

Activity modification

Oral pharmacotherapy

Non-steroidal anti-inflammatory drugs

Exercise and physiotherapy

Education plus exercise program

Corticosteroid injection

Peritrochanteric corticosteroid injection

Second-line interventions

Extracorporeal shockwave therapy (ESWT)

PRP injection

Surgical management

Surgical indications and options

Special Populations

Pregnancy

Pregnancy-specific considerations

Geriatric

Geriatric-specific considerations

Pediatrics

Pediatric considerations

Background

Epidemiology

Prevalence and incidence

Pathophysiology

Anatomical basis

Mechanistic understanding

Therapeutic Considerations

Evidence hierarchy for treatment

Conceptual framework

Patient Discharge Instructions

copy discharge instructions

Diagnosis explanation

Activity instructions

Medication instructions

Exercise and physiotherapy

Return to emergency department

References

Guidelines and key sources

Primary evidence base

Supporting references

Additional literature

SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.