30 year old male who is positive for HIV and on antiretroviral therapy has pain in right hip region. Flexion, abduction and external rotation deformity of right hip for 2 months. What is the most likely diagnosis?
High-Yield Explanation
Stages of Tb hip: I.Stage of synovitis: The hip joint is held in flexion, external rotation and abduction causing apparent lengthening(FABER) Joint is in position of maximal capacity. II.Stage of early ahritis: Damage to aicular cailage sets in. Deformity: flexion, adduction and internal rotation(FADIR). Shoening<1cm. III. Stage of advanced ahritis: Fuher advancement of destruction and above clinical signs IV. Advanced ahritis with subluxation or dislocation. TB hip in HIV AVN hip in HIV Incidence More Common Less Common Deformity FABER-stage of synovitis may be prolonged on treatment, then subsequently with onset of ahritis - FADIR ensues. Limitation of abduction and internal rotation so initially position is adduction and external rotation (opposite to movements limited) and than subsequently with onset of ahritis FADIR ensues. Unilateral (usually) Bilateral (usually)