Hip Pain

Hip pain and hip disorders are more common than realised, likely due to the difficulty with diagnosing them accurately. Several body areas can refer pain to the hip area, including the lumbar spine, the sacroiliac joints, pelvic structures, buttock syndromes and the hip joint itself.

Hip pain problems can be classified according to the age group they occur in, and whether they include joint stiffness with or without pain, or normal joint motion with hip pain.

Age-related classification of hip disorders:

Newborn babies

• Developmental Dysplasia of the Hip (DDH), formerly called Congenital Dislocation of the Hip (CDH)

Young children approx 4-12 years

• Perthes’ disease (Legg-Calve-Perthes disease) occurs when the upper growth plate of the thigh bone (femur), just below the ball of the hip, loses its blood supply. The bone of the ball then dies and can regain its blood supply over time.

It is not a common syndrome, with about one in 1200 children under 15 years in the US affected. It is a self-limiting condition but the results can vary from a normal hip to significant osteoarthritis.

• Tuberculosis

• Transient (short-lived) arthritis. This is a common cause of hip pain and limping in young children and the cause is not known. It tends to settle on its own and leave no lasting problems, although it can recur.

Transient arthritis presents as similar to septic arthritis (a serious infection) so the diagnosis needs to be made accurately. If transient arthritis is the diagnosis, the treatment is rest, anti-inflammatory drugs and time.

Older children, approx 12-17 years

• Slipped capital femoral epiphysis (SCFE), also called slipped upper femoral epiphysis (SUFE)

• Osteochondritis dissecans

Adults

• Osteoarthritis (OA), the most common degenerative joint condition.

• Rheumatoid arthritis (RA), an inflammatory arthritis, more common in women.

• Ankylosing spondylitis (AS), an inflammatory arthritis more common in men.

• Bursitis, an inflammation of the small lubricating sacs which the body has in areas where structures pass across each other and cause friction.

• Loose bodies in the joint