| Summary points: | A 79-year-old retired physician presents with bilateral hip pain, with occasional radiation to the groin, that had been present for approximately 2 years but had become increasingly bothersome over the previous 3 months and was no longer managed with acetaminophen. The patient voiced concern about nonsteroidal anti-inflammatory drug therapy because of potential gastrointestinal side effects and was reluctant to retry opioid therapy since he had previously experienced lightheadedness. Medical history (which included coronary artery disease and 3 prior myocardial infarctions), physical examination, flexion-abduction-external rotation provocative testing, treatment, and physical therapy are described. The authors discuss options for managing symptoms of osteoarthritis and cardiovascular disease. |