Hip pain

This page is for adult patients. For pediatric patients, see: hip pain (peds)

Background

Hip anatomy.

Extracapsular ligaments (anterior right hip).

Extracapsular ligaments (posterior right hip).

Gluteal muscles that move the femur (anterior view).

Additional deeper muscles that move the femur.

Gluteal muscles that move the femur (posterior view).

Cross section of the right hip at the level of the acetabulum.

• Hip pathology is commonly referred to the buttocks, thigh, groin, and knee
• AAA rupture may manifest as hip pain

Clinical Features

• Hip pain

Differential Diagnosis

Hip pain

Acute Trauma

• Femur fracture
  • Proximal
    • Intracapsular
      • Femoral head fracture
      • Femoral neck fracture
    • Extracapsular
      • Intertrochanteric femur fracture
      • Trochanteric femur fracture
  • Shaft
    • Mid-shaft femur fracture (all subtrochanteric)
• Hip dislocation
• Pelvic fractures
  • Acetabular pelvic fractures
  • Open book pelvic fracture
  • Straddle pelvic fracture
  • Pelvic avulsion fracture

Chronic/Atraumatic

• Hip bursitis
• Psoas abscess
• Piriformis syndrome
• Meralgia paresthetica
• Septic arthritis
  • Septic arthritis of the hip (peds)
• Obturator nerve entrapment
• Avascular necrosis of hip

Evaluation

Workup

• Consider hip x-ray
  • If negative and patient is unable to ambulate, typically requires MRI to rule-out occult fracture
• Consider CBC/C7/Coags

See Also

• Hip Pain (Peds)