What are the causes of hip pain in a young adult?

From the Guidelines

Hip pain in young adults is most commonly caused by femoroacetabular impingement (FAI) syndrome, acetabular dysplasia and/or hip instability, and other conditions without distinct osseous morphology, such as labral, chondral, and ligamentum teres conditions, as recommended by the International Hip-related Pain Research Network 1.

Causes of Hip Pain

The causes of hip pain in young adults can be categorized into three main conditions:

• Femoroacetabular impingement (FAI) syndrome
• Acetabular dysplasia and/or hip instability
• Other conditions without distinct osseous morphology, such as labral, chondral, and ligamentum teres conditions It is essential to exclude non-musculoskeletal and serious hip pathological conditions, such as tumors, infections, and stress fractures, as well as competing musculoskeletal conditions, like lumbar spine issues, before diagnosing hip-related pain in young and middle-aged active adults 1.

Diagnostic Approach

A comprehensive diagnostic approach, including patient symptoms, clinical signs, and diagnostic imaging, is recommended to diagnose hip-related pain in young adults, as the diagnostic utility of clinical examination and diagnostic imaging in isolation is limited 1.

Treatment and Prevention

Treatment for hip pain in young adults typically begins with rest, ice, and anti-inflammatory medications, and may include physical therapy, imaging studies, corticosteroid injections, or surgical intervention for persistent pain 1. Maintaining proper body mechanics during activities, wearing appropriate footwear, and avoiding sudden increases in exercise intensity can help prevent many causes of hip pain 1.

From the Research

Causes of Hip Pain in Young Adults

• Hip pain in young adults can be caused by various factors, including:
  • Congenital hip dysplasia 2
  • Athletic injuries 2, 3
  • Trauma 2, 3
  • Spondyloarthropathy 2
  • Rheumatoid arthritis 2
  • Osteoarthritis 2, 4
  • Intravenous drug use 2
  • Alcoholism 2
  • Corticosteroid use 2
• Subtle hip shape abnormalities, such as femoroacetabular impingement, can also cause symptomatic soft tissue damage and may initiate osteoarthritis 4, 5

Diagnosis and Investigation

• A systematic approach to investigating the etiology of hip pain in adults, including history, careful clinical and radiographic examination, can help identify the majority of clinically important pathologies 6
• Plain radiography and magnetic resonance imaging are the preferred initial imaging procedures 2
• Analyses of the blood, urine, and synovial fluid can be helpful in diagnosing inflammation, infection, and systematic rheumatic disease 2

Treatment and Management

• Medical treatment often involves patient education, physical therapy, and pharmacotherapy 2
• Acetaminophen, nonsteroidal anti-inflammatory drugs, and opioids for pain and antibiotics for infection are the most often prescribed drugs for this population 2
• Conservative treatment and selective use of injection therapies has proven quite successful for the treatment of most causes of hip pain 6