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The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve

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Pain images: hip pain--wrong diagnosis, wrong operation.

Dick Ongley¹, Edward Shipton

¹Department of Anaesthesia, University of Otago, Christchurch, New Zealand.

Pain Medicine (Malden, Mass.)

|May 12, 2010

Summary

A retroperitoneal schwannoma caused a woman's neuropathic hip pain, which was initially misdiagnosed as osteoarthritis. Prompt diagnosis and investigation are crucial for effective management of rare tumors presenting with pain.

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Last Updated: Jun 13, 2026

The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve

The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve

Published on: September 7, 2022

Area of Science:

Oncology
Neurology
Surgical Pathology

Background:

Schwannomas are rare tumors arising from nerve sheath cells.
Retroperitoneal schwannomas can present with vague or referred pain symptoms.
Neuropathic pain can be challenging to diagnose and manage.

Observation:

A 67-year-old woman presented with left hip pain radiating to the thigh and knee.
Initial diagnosis suspected osteoarthritis, leading to a hip replacement.
Post-surgery, pain persisted, prompting further investigation.

Findings:

Extensive investigations revealed a 54 mm retroperitoneal schwannoma as the cause of neuropathic pain.
The tumor's location and nature were confirmed through advanced imaging and diagnostic procedures.

Implications:

This case highlights the importance of thorough diagnostic workup for persistent pain, even after initial treatments.
It underscores the principle that surgery should only be considered when a diagnosis is definitive.
Emphasizes the need for comprehensive assessment and investigation when diagnostic uncertainty exists.