Session Information
Session Title: AA 2022 Posters - Musculoskeletal and Sports Medicine
Session Time: None. Available on demand.
Disclosures: Elizabeth E. Brown, MD: No financial relationships or conflicts of interest
Case Diagnosis: Tenosynovial giant cell tumor of the left hip
Case Description or Program Description: A runner presented with lower back pain and left posterior thigh discomfort for 3 months. She was started in physical therapy and prescribed non-steroidal anti-inflammatory drugs (NSAIDs) with mild improvement. 9 months from the time of initial evaluation the patient re-presented with new radiating pain and numbness in her left posterior thigh to her ankle that was exacerbated by running. She had an intact neurological exam with mild pain provoked in the left buttock during left hip internal rotation and at end range of lumbar flexion. Subsequent physical therapy and continued NSAIDs were of minimal benefit. Magnetic resonance imaging (MRI) of the lumbar spine showed an annular tear at L5-S1 and the patient underwent a left transforaminal epidural steroid injection at this level with no change in symptoms. Electrodiagnostic testing of her left lower extremity was normal. At this point MRI of the left hip was ordered given persistence of symptoms and lack of response to therapy.
Setting: Academic sports medicine clinic in a freestanding rehabilitation hospital
Assessment/Results: MRI left hip showed a 2.6 x 2.1 x 2.8 cm mass deep to the gluteus maximus and separate from the sciatic nerve. She was referred to Orthopedic Oncology and underwent mass resection with pathology showing Tenosynovial Giant Cell Tumor (TGCT). Post-operatively her pain resolved, but she continued to have left foot numbness. She is currently in physical therapy with a plan to return to running.
Discussion (relevance): Persistent lower back pain with radicular features in an active, young person warrants further work up, potentially including imaging of the hip.
Conclusions: To our knowledge this is an extremely unique case of a TGCT causing posterior thigh pain mimicking lumbar radiculopathy.
Level of Evidence: Level IV
To cite this abstract in AMA style:
Brown EE, Jayabalan P. A Rare Case of Tenosynovial Giant Cell Tumor of the Hip Posing as Lumbar Radiculopathy in a Runner: A Case Report [abstract]. PM R. 2022; 14(S1)(suppl 1). https://pmrjabstracts.org/abstract/a-rare-case-of-tenosynovial-giant-cell-tumor-of-the-hip-posing-as-lumbar-radiculopathy-in-a-runner-a-case-report/. Accessed May 16, 2025.« Back to AAPM&R Annual Assembly 2022
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/a-rare-case-of-tenosynovial-giant-cell-tumor-of-the-hip-posing-as-lumbar-radiculopathy-in-a-runner-a-case-report/