A chronic case of lower back pain in a young female is presented. A number of conditions can lead to back pain. This article discusses the sequelae of osteonecrosis of the hip and how it resulted in a leg length discrepancy leading to altered lumbo-pelvic biomechanics and its genesis of lower back pain. Diagnostic imaging and clinical manifestations are discussed in detail. Early diagnosis is important for appropriate treatment and to decrease the severity of deformity.
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