2. Pain in the gluteal region Q

A middle aged male presented with complaints of pain in the right gluteal region. The pain started spontaneously and hampered him from walking. The pain was worse with movement especially in getting up from sitting and climbing stairs. It was relieved temporarily with the use of NSAIDs. There was no associated back pain, no pain on the anterior or medial aspect of the thigh or below the knee. There was no history of numbness or paresthesias. On examination pain was reproduced particularly during extension and internal rotation of the hip. There was no local tenderness and no obvious lesions on the skin.

 

What is the cause of this patient's pain?

How is he to be evaluated? 

1. A patient with diabetes Q

A 65 year patient presents at an outpatient clinic for evaluation. She is a diabetic since 20 years and is currently on Insulin (isophane insulin 6 U at night & regular insulin 24-30-22 U before food). She was previously on oral hypoglycemic agents but has been on insulin since 6 years.

What are the possible reasons why OHAs would have been discontinued?

She complains of imbalance while walking. What are the additional signs that you want to look for?