Hip pain in adults

Question 1

Pain exacerbated by exercise and relieved by rest
Reduction in internal rotation is often the first sign
Age, obesity and previous joint problems are risk factors

Answer 1

osteoarthritis

Question 2

Pain in the morning
Systemic features
Raised inflammatory markers

Answer 2

inflammatory arthritis

Question 3

Femoral nerve compression may cause referred pain in the hip
Femoral nerve stretch test may be positive - lie the patient prone. Extend the hip joint with a straight leg then bend the knee. This stretches the femoral nerve and will cause pain if it is trapped

Answer 3

referred Lumbar spine pain

Question 4

Due to repeated movement of the fibroelastic iliotibial band
Pain and tenderness over the lateral side of thigh
Most common in women aged 50-70 years

Answer 4

Greater Trochanteric pain of the hip (Trochanteric bursitis)

Question 5

Caused by compression of lateral cutaneous nerve of thigh
Typically burning sensation over antero-lateral aspect of thigh

Answer 5

Meralgia paraesthetica

Question 6

Symptoms may be of gradual or sudden onset
May follow high dose steroid therapy or previous hip fracture of dislocation

Answer 6

AVN of hip

Question 7

Common in pregnancy
Ligament laxity increases in response to hormonal changes of pregnancy
Pain over the pubic symphysis with radiation to the groins and the medial aspects of the thighs.
A waddling gait may be seen

Answer 7

Pubic symphysis dysfunction

Question 8

An uncommon condition sometimes seen in the third trimester of pregnancy
Groin pain associated with a limited range of movement in the hip
Patients may be unable to weight bear
ESR may be elevated

Answer 8

Transient idiopathic osteoporosis