During a consultation, your doctor will use various techniques in his assesment of the symptom: Hip pain. These may include a physical examination or other medical tests. Your doctor may ask several questions when assessing your condition. It is important to remember that your consultation is a two-way process and any extra information you can share with your doctor may help them with their diagnosis.
Some of the questions your doctor may ask are listed below:
Why: to determine if acute or chronic.
Why: pain associated with the hip joint is usually described as a deep aching pain, aggravated by movements and felt in the groin and front to inner side of the upper thigh, sometimes exclusively around the knee.
Why: pain in the hip, buttock, groin and upper thigh tend to be related. True hip pain is usually groin pain or is referred to the inner aspect of the knee.
Why: would suggest that there may be a fracture or sprain of the hip joint. Note a fracture of the hip in the elderly can often occur with no history of trauma.
Why: may help to determine risk of sporting trauma or overuse injuries.
Why: e.g. previous trauma to hip, congenital dislocation of the hip, acetabular dysplasia, slipped upper femoral epiphysis and past inflammatory arthritis.
Why: may be relevant for sacro-iliac pain.
Why: hip pain has a significant age relationship. From newborn to age 4 need to consider congenital dislocation of the hip. From age 4 to age 8 need to consider Perthes' disorder or transient synovitis of the hip. From age 10 to age 15 need to consider Slipped upper femoral epiphysis (SUFE). After the age of 40 need to consider a variety of diagnoses including sciatica, intermittent claudication, osteoarthritis and fractures.
Why: e.g. osteoarthritis, rheumatoid arthritis, inflammatory bowel disease, ankylosing spondylitis, psoriasis.
Sometimes, other symptoms may be present and may help your doctor analyse your condition. These may include:
Why: Morning stiffness classically occurs in Rheumatoid arthritis and other inflammatory arthropathies (such as ankylosing spondylitis, Reiter's syndrome, psoriatic arthritis); Polymyalgia rheumatica.
Why: Pain originating from disorders of the lumbosacral spine may radiate to the hip joint.
Why: Pain originating from disorders of the knee may radiate to the hip joint and pain from the hip joint may be referred to the thigh and knee.
Why: disorders of the abdomen may cause hip and groin pain.
Why: consider any disorder of the hip joint.
Why: may suggest polymyalgia rheumatica.
Why: must consider septic arthritis, osteomyelitis, rheumatoid arthritis, pelvic inflammatory disease, pelvic abscess, ischiorectal abscess, tuberculosis.
Why: may indicate inflammation, bursitis or bone tumor.
Why: e.g. may present from age 1 to 4, walks with a limp (if walking) however usually nil pain, bilateral in 1/3 of cases, short leg may be evident.
Why: e.g. may present from age 4-8 with an aching hip, walks with a limp, sometimes may be bilateral. Occurs in males: females in a ratio of 4:1.
Why: e.g. may present in a child from age 4-8 with a sudden onset of hip pain and limp. There may be a history of trauma. The child can usually walk (some may not).
Why: e.g. may present in a child from age 10-15 with a limp, irritability of hip on most movements and knee pain. Most common in the oversized and undersexed such as the obese pre-pubertal boy. May be bilateral in 20 %.?
Why: e.g. presents usually after age 50, may be bilateral usually starting in the one hip and following in the other, insidious slow onset. At first pain is worse with activity and relieved by rest, then later get night time pain and pain after resting. Hip stiffness , especially after rising is a feature. Walks with a limp with the leg deviated inwards towards the other leg and the foot slightly turned outwards.
Why: e.g. usually have a dull ache in the buttock but can be referred to the groin or posterior aspect of the thigh. Pain may be unilateral or bilateral. May have a heavy aching feeling I the upper thigh. May be due to ankylosing spondylitis, Reiter's syndrome, psoriatic arthritis, enteropathic arthritis (due to Crohn's disease or ?ulcerative colitis), infection such as tuberculosis, osteitis condensans ilii, osteoarthritis or trauma.
Why: e.g. pain on the outer side of hip radiating down the outer side of the thigh. The pain of bursitis tends to occur at night. The pain of tendonitis occurs with such activity as long walks and gardening.
Why: e.g. typically occurs in ages 60-70 presenting with pain and stiffness in shoulder, hip and cervical spine; symmetrical distribution; early morning stiffness. May be systemic signs such as weight loss, loss of appetite and fatigue. Painful restriction of movement of shoulders and hips.
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