A female in her 70’s presented to physical therapy (PT) with right lateral knee pain that had been present and recently worsening for one and a half years. The PT exam did not have significant findings at the right knee but there were findings at the right hip. Physical therapy treatment was initiated but the therapist recommended imaging of the right hip. Radiographs showed severe osteoarthritis of the right hip, and a referral was made to an orthopedic surgeon with a subsequent total hip arthroplasty. The patient had relief of both hip and knee pain and returned to her prior level of function. This case emphasizes the importance of a thorough musculoskeletal exam and the use of imaging to provide the best plan of care for a patient.

Keywords: Physical therapy; Orthopedics; Imaging; Referral