<s>[INST] 55 year old white male. Bilateral hip and leg pain at rest and worse with walking. Right shoulder pain and right arm numbness. No falls. He went to a local ER and they would not X-ray because he reported that he had not fallen. Trying to get into a physician but no insurance. Illinois Medicare is slow and he is waiting on approval. He has had two courses of steroids and muscle relaxers. Pain nit relieved with Tramadol. [/INST] Hello, I have studied your case. Pain around joint which can be due to avascular necrosis hip.Also, there can be hip arthritis which can be degenerative or due to avascular necrosis of femoral head [AVN]. I will advise you do MRI of hip, and you can consult me with reports or with your doctor. Till time take analgesic and cartilage protecting medication like glucosamine sulfate. For hip arthritis joint flexion, extension and rotation exercises will help. Physiotherapist will help you better to learn more exercises in proper protocol. Diet rich in calcium and protein will help. I will advise checking your it B12 and it D3 level. You should consult orthopedic specialist for clinical examination and further management. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care. </s>