Diagnostic Tests for Hip pain

Diagnostic Test list for Hip pain:

The list of diagnostic tests mentioned in various sources as used in the diagnosis of Hip pain includes:

• Physical examination
  • Observe gait when walking - e.g. if walking with a limp, with the leg deviated inwards towards the other leg and the foot slightly turned outwards, the likely diagnosis is osteoarthritis.
  • Note position of leg when the person is laying flat - e.g. if after an injury or fall, the leg is shortened and turned outwards a fractured neck of the femur is the likely diagnosis; if the leg is turned inwards must suspect posterior dislocation of the hip.
  • Feel the front of the hip joint for joint tenderness and the side of the thigh for tenderness which may suggest trochanteric bursitis or gluteus medius tendonitis
  • Test range of movement of the hip joint
  • Measure leg length to detect inequalities
  • Also examine lumbosacral spine, sacro-iliac joints, groin and knee joints
  • Examine for a positive straight leg raising test (straightening the leg at the knee while lying on a bed causing pain in thigh, buttock and back) - indicates herniated disk, lumbar spondylosis, spinal stenosis, cauda equina tumor or spondylolisthesis.
  • Examine peripheral pulses (if absent or reduce may suggest aorto-iliac arterial occlusion causing vascular claudication as the cause of hip or buttock pain)
• Blood tests
  • Full blood count and ESR (ESR may be mildly elevated in transient synovitis)
  • Biochemistry
  • Rheumatoid factor
  • Serum protein electrophoresis (if suspect multiple myeloma)
• Radiological investigations
  • Plain X-Ray of the hips and lumbosacral spine
  • X-Ray hips with special frog views in children
  • Bone Scan may be necessary to diagnose occult fractures
  • Ultrasound of hip (now sensitive for detecting fluid in the hip joint and may help in diagnosing septic arthritis, osteomyelitic abscesses, transient synovitis, and congenital dislocation of the hip in newborn babies)
  • CT Scan of hip
  • MRI hip is especially important if suspect diagnosis of avascular necrosis

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