Guide for Diagnosing Hip Pain in Young Adults
More and more young adults are showing up in doctors' offices with hip pain. Increased activity and sports participation may be part of the reason for this problem. On the other side of things, inactivity and obesity may be at fault. In either case, increased wear on the hip joint results in hip pain.
In this review, the key elements of patient exam and workup are presented for diagnosing the problem. The doctor must consider hip-related and nonhip-related disorders when looking for the cause of the problem.
The low back and sacroiliac joints can refer pain to the hip. So can some intestinal, kidney, and gynecologic problems. Hip and groin pain in men can be caused by prostate or testicular problems.
When hip pain is really coming from the hip, there can be many different underlying problems. Degenerative joint disease, impingement, cartilage tears, and bursitis are just a few of the more common conditions causing hip pain.
More serious problems such as fracture and dislocation must be considered. In rare cases, tumors or infection may be the cause of hip pain. In all cases, the surgeon relies on the patient's history and a physical exam to make the initial diagnosis. Tests for motion, soft tissue tightness, and cartilage tears are carried out in the office.
Depending on the results of the initial exam, further testing such as X-rays, CT scans, or MRIs may be needed. Specifics in diagnosing osteoarthritis, impingement, osteonecrosis (bone death), and labral tears are offered. Bursitis, stress fractures, snapping hip syndrome, and inflammatory arthritis are also included.
Risk factors, symptoms, and specific tests for each of these problems are discussed. A brief mention of treatment for each diagnosis is included. The authors promise a second article in a later issue of this journal to expand on the treatment of these various hip problems.
Robert Norton and Javad Parvizi, MD. Hip Pain in Young Adults: Making a Difficult Diagnosis. In The Journal of Musculoskeletal Medicine. December 2006. Vol. 23. No. 12. Pp. 857-872.