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Hip pain. Don't throw away the cane
1Jewett Orthopaedic Clinic, Winter Park, FL 32789.
Insights
Osteoarthritis and rheumatoid arthritis cause most hip pain. Accurate diagnosis relies on clinical examination, as lab tests are often unhelpful for hip conditions.
Area of Science:
- Orthopedics and Rheumatology
- Diagnostic Medicine
Background:
- Hip pain is a common ailment with osteoarthritis and rheumatoid arthritis accounting for 90% of diagnoses.
- Differential diagnoses include fractures, synovitis, avascular necrosis, and conditions mimicking hip disease like nerve root pressure syndrome, trochanteric bursitis, and vascular insufficiency.
Purpose of the Study:
- To highlight the primary causes of hip pain and emphasize diagnostic strategies.
- To underscore the importance of clinical evaluation over laboratory studies for hip conditions.
- To outline conservative treatment approaches and the necessity of second opinions for surgical consideration.
Main Methods:
- Review of common hip pathologies and conditions that present with similar symptoms.
- Emphasis on clinical examination and patient history for accurate diagnosis.
- Discussion of conservative management and surgical decision-making protocols.
Main Results:
- Osteoarthritis and rheumatoid arthritis are the leading causes of hip pain.
- Clinical assessment is more valuable than laboratory tests in diagnosing hip conditions.
- Mimicking conditions and concomitant pathologies require careful consideration during evaluation.
Conclusions:
- Accurate diagnosis of hip pain relies heavily on thorough clinical examination and awareness of differential diagnoses.
- Conservative treatment is recommended when feasible, with surgical intervention requiring careful consideration and multiple opinions.
- Understanding both direct hip pathologies and mimicking conditions is crucial for effective patient management.
Abstract:
The most common cause of hip pain is osteoarthritis, which when combined with rheumatoid arthritis accounts for 90% of all hip pain diagnoses. Other conditions of the joint include fractures, synovitis, and avascular necrosis. There are three major conditions that mimic hip disease: nerve root pressure syndrome, trochanteric bursitis, and vascular insufficiency. Laboratory studies are often of little value for diagnosis. Careful examination and an awareness of possible mimicking and concomitant conditions can be more helpful. Treatment of hip disease should be conservative as long as the patient can tolerate the discomfort and inconvenience. Early treatment may include the use of a cane. If surgery is contemplated, insist that the patient get at least two opinions regarding the need for and type of surgery to be recommended.