Hip pain follows a recognisable pattern: it is felt in the groin, radiates down the front of the thigh and often reaches the knee. Patients typically grip the area between thumb and index finger in a C shape. Pain in the buttock or on the outer side usually has a different origin — the lumbar spine or the tendons around the greater trochanter.
Stiffness in the morning or after sitting that eases within minutes. Difficulty putting on socks and shoes or cutting toenails. A walking distance that keeps shrinking. A limp. And, in advanced disease, pain at night. On examination, internal rotation is the first movement to be lost.
Osteoarthritis is the most common. Next come avascular necrosis of the femoral head, which often affects patients in their thirties and forties and progresses silently, adult dysplasia and femoroacetabular impingement with labral tearing, fractures, tendon and synovial inflammation, and problems following a previous replacement.
Several of these conditions have a window during which the joint can still be preserved. In avascular necrosis that window closes when the femoral head collapses. In impingement it closes when the cartilage is destroyed. An early MRI in a patient with unexplained hip pain and a risk factor is often the single most decisive investigation.
See also the hip surgery techniques used to treat these conditions.
to guide you about your condition, to choose the best possible treatment.
