The table below provides a brief summary of the potential causes of hip pain in adults
| Condition | Features |
|---|---|
| Osteoarthritis | 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 | |
| Inflammatory arthritis | Pain in the morning |
| Systemic features | |
| Raised inflammatory markers | |
| Referred lumbar spine pain | 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 | |
| Greater trochanteric pain syndrome (Trochanteric bursitis) | 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 | |
| Meralgia paraesthetica | Caused by compression of lateral cutaneous nerve of thigh |
| Typically burning sensation over antero-lateral aspect of thigh | |
| Avascular necrosis | Symptoms may be of gradual or sudden onset |
| May follow high dose steroid therapy or previous hip fracture of dislocation | |
| Pubic symphysis dysfunction | 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 | |
| Transient idiopathic osteoporosis | 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 |