HIP PAIN: DIFFERENTIAL DIAGNOSIS

HIP PAIN: DIFFERENTIAL DIAGNOSIS
Arthroscopy, 2008
Tibor LM, Sekiya JK
The differential diagnosis of hip pain is wide and includes intra-articular conditions, extra-articular conditions and problems arising from the other joints of the pelvic ring. With the recent advances in hip arthroscopy, more patients are being assessed for hip pain. Our understanding of the functional anatomy around the hip has improved in recent years. In addition, thanks to progress in magnetic resonance imaging, the diagnosis of soft-tissue disorders around the hip has also improved. All these advances have broadened the differential diagnosis of hip pain and have improved the treatment of these problems. This review discusses the causes of intra-articular hip pain that can be managed arthroscopically: tear of the labrum, loose bodies, femoroacetabular impingement, capsular laxity, tears of the ligamentum teres and chondral lesions. The extra-articular causes of hip pain that can also be managed arthroscopically are discussed as well. These causes include iliopsoas tendinitis, “internal” snapping hip, “external” snapping hip, the iliotibial band and greater trochanteric bursitis, and injury of the gluteal tendons. Finally, the extra-articular causes of hip pain that are usually managed conservatively or by open surgery are discussed: stress fracture of the femoral neck, adductor strain, piriformis syndrome, pain from the sacroiliac joints, athletic pubalgia, “sports hernia”, Gilmore’s groin and osteitis pubis.