Hip Pain

01.04.2020

Hip Pain

Pain in the hip usually starts very gradually, in rare cases accidents can also cause acute pain.

It is typical for hip pain to be felt in the groin. However, it also happens that they occur on the side of the hip or rather at the back of the buttocks.

Most common location of hip disease pain

 

 

 

 

 

 

 

 

 

 

 

 

Many diseases can result pain in and around the hip. The most common area:

1. Osteoarthritis of the Hip Joint as a Result of:

  • Incarceration syndrome of the hip (up to 60%)
  • Maldevelopment of the hip (hip dysplasia)
  • Circulatory disorder of the femoral head (femoral head necrosis)
  • Childhood diseases (e.g. Perthes disease)
  • Accident

2. Incarceration Syndrome of the Hip
3. Labrum Tear, Cartilage Camage as a Result of:

  • Incarceration syndrome of the hip
  • Maldevelopment of the hip (hip dysplasia)

4. Bursitis, Torn Tendon (bursitis trochanterica, torn tendon of the gluteus medius/minimus muscles)
5. Snapping Hip
6. Piriformis Syndrome

The various causes of hip complaints occur with differing frequency depending on age. In addition, the cause of the pain can be located in the hip joint itself or outside the hip joint. The causes are listed below.

In young adults

Inside the Hip Joint:

  • Hip Impingement (most common)
  • Tear of the joint labrum – or labrum tear often in the context of impingement syndrome of the hip
  • Cartilage damage caused by impingement syndrome, hip dysplasia or childhood hip disorders.
  • Internal Snapping Hip – internal hip snapping caused by tendon jumping directly at the joint or labrum tear
  • Free Joint Bodies – causes snapping, cracking
  • PVNS – pigmented villonodular synovitis – proliferation of the synovial membrane, which can be locally destructive (rare)

Outside the Hip Joint:

  • Rectus emulsion: Torn out bone tendon of a thigh muscle, which can later simulate an impingement syndrome (subspine impingement)
  • Ischiofemoral Impingement – pinching of the soft tissues between the ischium and the femur
  • External Snapping Hip – Hip snapping is caused externally to the hip (tractus iliotibialis).
  • Sports Hernia – Athletes’ groin or “sportsmen’s hernia Irritation of the ilioinguinal and iliohypogastric nerve due to too loose support of the nerve. No actual hernia (break).
  • Athletic Pubalgia – pain in the middle of the pubic bone
  • Ischial Pain – irritation or tearing of the tendons of the posterior thigh muscles, rarely bursitis
  • Piriformis Syndrome – deep buttock pain with hip flexion

In mature adulthood:

  • Hip Osteoarthritis – wear and tear of the cartilage of the hip joint. This can be painful however not visible on the x-ray. Or it is overstrechted and is easily visible on the x-ray. Hip Osteoarthritis
  • Tear of the Tendons of the Gluteal Muscles (musculus gluteus medius/ minimus) – or wear at the tendon insertion
  • Piriformis Syndrome – deep buttock pain with hip flexion
  • Spinal Problems – disc degeneration, spinal stenosis or arthrosis of the small vertebral joints, these can radiate into the hip region.

Diagnostic Infiltration Test Syringe

When the source of pain is unclear, the possibility of infiltrating (injecting) the hip joint with local anaesthetic exists.

In some cases, radiological imaging reveals visible changes in both the hip and the lumbar spine. Possibly there are complaints of the cross or lumbar spine, which can radiate into the hip. Here too, a so-called test infiltration into the hip joint is helpful. This eliminates complaints originating in the hip joint, but not pain whose cause lies outside the joint.

If the pain improves significantly for about 1.5 hours afterwards, the test is positive. This means that the pain originates from the hip joint.

Back to selection