Assignment task:
A 42-year-old man with a history of total hip arthroplasty presented for first-time visit with complaints of hip pain. One year ago he had a displaced left femoral neck fracture requiring total hip arthroplasty with subsequent chronic hip pain. His pain was managed by his orthopedist, originally with oxycodone and more recently with ibuprofen. A recent extensive reevaluation of his hip pain was negative.
He requested that his orthopedist prescribe something stronger like "oxys" for his pain, as the ibuprofen was ineffective. He was told to discuss his pain management with his primary care physician (you). He's been on disability since his hip surgery and lives with his wife and two children. He denies current or past alcohol, tobacco, or drug use.
Currently, he's on ibuprofen 800 mg three times per day. He walks with a limp and uses a cane. His vitals are normal. He's 6 feet tall and weighs 230 pounds. He has a large, well-healed scar over the left lateral thigh and hip area with no tenderness or warmth over the hip. He has full range of motion. He doesn't want to return to his orthopedist, because "he doesn't believe that I'm still in pain." Need Online Help?