02 May 2018
There may be a number of causes of pain around the hip and it is important to consider sources other than the hip joint itself. Pain originating from from the lumbar spine is generally felt around the buttock, whereas pain from the hip joint itself is most often from the groin and felt down the front of the thigh.
Inguinal hernia can be excluded by examination of the groin, and vascular impairment, which can cause pains around the buttock and leg, can often be excluded simply by taking a medical history and examination.
Pain at the lateral or outside part of the hip may be from the muscles or greater trochanter area, commonly a trochanteric bursitis or tendonitis of the gluteus medius muscle, one of the three gluteal muscles situated on the outer surface of the pelvis.
In younger patients with groin pain, we need to consider femoro acetabular impingement - a condition where extra bone grows along one or both of the bones that form the hip joint giving the bones an irregular shape. Because they do not fit together perfectly, the bones rub against each other during movement. A history of clicking sensation may also be present. Psoas tendinitis, which is an inflammation of the tendon or area surrounding the tendon, should also be considered. Adductor muscle strain (groin strain) generally will follow a history of sporting injury. Specific examination tests will usually help in making the diagnosis in these conditions.
Further tests would include plain X-Rays, blood tests if an inflammatory /rheumatic condition is considered and an MRI scan. Conservative or non operative treatments are generally tried first, for example physiotherapy or cortisone injections. If patients do not respond well to conservative measures, then surgery may be recommended, for example total hip replacement for osteoarthritis or key hole surgery - or hip arthroscopy - for labral tears.
Mr Gian C Singer is a Consultant Hip Orthopaedic Surgeon here at Spire Thames Valley. If you have any concerns about your hip, please feel free to book an appointment by calling 01753 665 404 or email us firstname.lastname@example.org.