24th February 2025

A 75-year-old man with a background of ischaemic heart disease, type 2 diabetes mellitus, hypertension and palliative lung cancer presents with a three-month history of progressive hip pain.

A 75-year-old man with a background of ischaemic heart disease, type 2 diabetes mellitus, hypertension and palliative lung cancer presents with a three-month history of progressive hip pain. The pain is constant and described as agony when he attempts to sleep at night. It is exacerbated by mobilising, and on occasions, it feels like it might ‘give way.’ Examination of his hip highlights a reasonable range of movement, though it is clearly causing pain and a limp when mobilising. Examination of his hands shows clubbing and both Bouchard’s and Heberden’s nodes, which are described as ‘slightly sore.’ Observations are unremarkable. What is the most appropriate next step?

Select the SINGLE most appropriate option from the list below. Select ONE option only.