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KMID : 0388720240310010018
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Journal of Korean Society of Spine Surgery
2024 Volume.31 No. 1 p.18 ~ p.22
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Hip Osteoarthritis Misdiagnosed as a Cervical Pathology: A Case Report
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Choi Sung-Woo
Hwang Jin-Yeong
Baek Seung-Lim
Lee Jae-Chul
Shin Byung-Joon
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Abstract
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Study design: Case report.
Objectives: To report a case of hip disease that was misdiagnosed as a cervical spine lesion.
Summary of Literature Review: Hip and/or knee osteoarthritis (OA) commonly results in gait impairment in elderly patients. Although the diagnosis is usually straightforward, clinicians should consider spinal lesions in the differential diagnosis because the symptoms may often be ambiguous and can overlap. Gait impairment is a primary symptom of cervical spondylotic myelopathy that manifests with a slow and wide-based ataxic gait.
Materials and Methods: A 73-year-old man was admitted with gait disturbance and pain radiating to his bilateral thighs. He was diagnosed with cervical myelopathy and underwent cervical fusion surgery at another hospital 1 year prior to presentation. However, he showed an antalgic gait pattern and he experienced intermittent pain originating at the lower back with radiation into the bilateral groins and knees. Initial magnetic resonance imaging (MRI) revealed herniated intervertebral disc-induced stenosis at the C4-5-6 levels.
One-year follow-up MRI revealed well-decompressed fusion at the C4-5-6 levels. Plain radiography of the pelvis and MRI of the hip joint revealed severe osteoarthritis, and he underwent bilateral total hip replacement arthroplasty.
Results: The patient reported significant improvement in pain and gait impairment postoperatively.
Conclusions: In the present case, the presentation of cervical spondylotic myelopathy accompanied by gait disturbance was the patient’s main symptom, together with few upper extremity symptoms. Clinicians should be mindful of the possibility that this condition may be misdiagnosed as hip or knee pathology.
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KEYWORD
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Misdiagnosis, Gait impairment, Hip spine syndrome, Hip osteoarthritis, Cervical myelopathy
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