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).

• 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)