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Chapter 19: Hip Pain

Kyle F. Baldwin; Todd E. Davenport; Michael A. Andersen

Description of the Symptom

This chapter describes pathology that may lead to hip pain, including anterior, buttock, inguinal/medial thigh, and lateral pain. Local causes of hip pain are defined as pathology occurring within the intra- and extra-articular structures of the hip joint. Remote causes are defined as originating from sites external to this region.

Special Concerns

  • Acute inability to bear weight through the affected lower extremity or pelvis secondary to pain

  • Decreased pulses in the lower extremities

  • Skin break and fever

  • Sudden loss of motor or sensory function associated with trauma

  • Warmth and swelling in the legs associated with a fever

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CHAPTER PREVIEW: Conditions That May Lead to Hip Pain
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CHAPTER PREVIEW: Conditions That May Lead to Hip Pain
T  Trauma
REMOTE LOCAL INGUINAL/MEDIAL THIGH LOCAL LATERAL LOCAL BUTTOCK LOCAL ANTERIOR HIP/THIGH
COMMON

Acute lumbar sprain/strain 324

Disk disruption (with or without herniation) 326

Facet syndrome 327

Lumbar compression fracture 328

Lumbar radiculopathies:

  • L1-L3 radiculopathy 328

  • L4 radiculopathy 328

  • L5 radiculopathy 330

  • S1 radiculopathy 330

Hernias:

  • Femoral hernia 340

  • Inguinal hernia 340

Labral tear 343

Muscle strains:

  • Adductor strain 343

  • Iliopsoas strain 343

Iliotibial band friction syndrome 343

Trochanteric contusion (hip pointer) 350

Fractures:

  • Avulsion fractures:

    • Hamstrings off ischial tuberosity 338

Gluteal contusion 339

Muscle strains:

  • Hamstring strain 343

Sacroiliac joint dysfunction 349

Labral tear 343

Muscle strains:

  • Iliopsoas strain 343

  • Quadriceps muscle strain 344
UNCOMMON
Not applicable

Fractures:

  • Intracapsular femur fracture 339

  • Stress fracture of the femoral neck 339

Hernias:

  • Sports hernia 340

Nerve entrapments/neuropathy:

  • Femoral neuropathy 344

  • Genitofemoral nerve entrapment 344

  • Iliohypogastric nerve entrapment 344

  • Ilioinguinal nerve entrapment 345

  • Obturator nerve entrapment 345

Sacroiliac joint dysfunction 349

Iliac crest apophysitis 342

Nerve entrapments/neuropathy:

  • Meralgia paresthetica 345

Bursitis:

  • Ischiogluteal bursitis 336

Nerve entrapments/neuropathy:

  • Piriformis syndrome 345

Fractures:

  • Extracapsular femur fracture 338

  • Femoral shaft fracture 339

Hernias:

• Sports hernia 340

Nerve entrapments/neuropathy:

  • Femoral neuropathy 344

  • Meralgia paresthetica 345
RARE
Traumatic spondylolisthesis 335

Fractures:

  • Acetabular fracture 337

  • Avulsion fractures:

    • Hamstrings off ischial tuberosity 338

    • Rectus femoris off anterior inferior iliac spine 338

    • Sartorius off anterior superior iliac spine 338

Hip dislocation 341

 Hip dislocation 341 Hip dislocation 341 Hip dislocation 341
I  Inflammation
REMOTE LOCAL INGUINAL/MEDIAL THIGH LOCAL LATERAL LOCAL BUTTOCK LOCAL ANTERIOR HIP/THIGH
COMMON

Aseptic

Not applicable

Septic

Appendicitis 326

 Not applicable

Aseptic

Bursitis:

  • Ischiogluteal bursitis 336

  • Trochanteric bursitis 336

Fibromyalgia 337

Septic

Not applicable

Aseptic

Fibromyalgia 337

Septic

Not applicable

Not applicable
UNCOMMON

Aseptic

Rheumatoid arthritis-like diseases of the lumbar spine:

  • Scleroderma 333

  • Systemic lupus erythematosus 333

Septic

Brucellosis of the lumbar spine 326

Pelvic inflammatory disease 331

Prostatitis 331

Renal or urinary tract infection 332

Septic arthritis of the sacroiliac joint 334

Aseptic

Complex regional pain syndrome 337

Iliopsoas tendinitis 342

Osteitis pubis 345

Reiter's syndrome 347

Rheumatoid arthritis of the hip 348

Rheumatoid arthritis-like diseases:

  • Scleroderma 348

  • Systemic lupus erythematosus 348

Septic

Herpes zoster 340

Aseptic

Complex ...

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