What is Hip Pain?
The reason I want to discuss “what hip pain is” is because it seems to cause a lot of confusion out in the community, especially among patients and sometimes even GP’s.
Hip pain usually relates to the groin and the anterior thigh. Most patients who have hip related and joint related pain complain of that. I think that they can also present with other symptoms, such as buttock pain and other aches and pains. But in general, what you look for specifically is groin and anterior thigh pain.
Sometimes patients with purely hip pain tend to present with anterior knee pain, and we need to differentiate that from actual knee pain.
Pain in the knee that radiates from the hip is very confusing and often you need to examine the knee, which is normal and not irritable, and then you'll find that the hip is very stiff and irritable. So, they're the things that I look for and there are often differential diagnoses that we don't think about, like hernias for general surgeons.
Further, sometimes osteitis pubis can cause groin pain, adductor groin strain, and we need to take a history for that. Other things, such as troconteric bursitis, don't tend to cause groin pain per se, unless they're associated with hip arthritis. So trocenteric bursitis is usually buttock related pain or posterior troconteric pain and tenderness and we need to be careful about that too, and not label that as hip pain.
The other problem that I see is that a lot of people with hip arthritis that present with groin pain also have back pain and spinal arthritis. And sacraliac joint arthritis is often associated with hip arthritis.
So again, we need to make sure that we can differentiate between those two problems, because often if a patient needs a hip replacement, the back pain may not improve. So we need to be careful to talk to our patients and counsel them about these things.
Other than that, I rely on X-rays to make the diagnosis and confirm my diagnosis, and if I'm not sure, I'll get an MRI scan.
In a nutshell, hip pain related to hip arthritis is groin pain and thigh pain, and sometimes knee pain unless proven otherwise.
Cheers,
EK.
PS. I’ve recently started a new Sunday series, “All things Ortho” that you can watch via my youtube channel where I share my thoughts and experiences as an experienced Orthopaedic surgeon. My latest video is online where I discuss “What is Hip Pain”?