Differential Diagnosis for Thigh Pain on Hip Flexion
Single Most Likely Diagnosis
- Quadriceps strain: This is the most likely diagnosis due to the location of the pain and the exacerbation of symptoms on hip flexion, which is a common movement that engages the quadriceps muscle. The muscle strain would also explain the tenderness to touch.
Other Likely Diagnoses
- Iliopsoas tendinitis: The iliopsoas tendon plays a significant role in hip flexion, and inflammation or irritation of this tendon could cause pain in the thigh area, especially when the hip is flexed.
- Femoral stress fracture: Although less common, a stress fracture in the femur could cause thigh pain that worsens with activity, including hip flexion. The bone might be tender to touch due to the fracture.
- Osteitis pubis: This condition involves inflammation of the pubic bone and surrounding structures, which could radiate pain to the thigh, especially with movements like hip flexion.
Do Not Miss Diagnoses
- Femoral artery aneurysm or thrombosis: Although rare, these vascular conditions could cause thigh pain and must be considered, especially if there are symptoms like coldness, pallor, or decreased pulses in the affected limb.
- Neoplastic processes (e.g., osteosarcoma, soft tissue sarcomas): Tumors in the thigh could cause pain and tenderness. While rare, missing a diagnosis of cancer could have severe consequences.
- Infectious processes (e.g., osteomyelitis, pyomyositis): Infections of the bone or muscle could present with pain, tenderness, and systemic symptoms like fever. These conditions require prompt diagnosis and treatment.
Rare Diagnoses
- Compartment syndrome: This is a condition where increased pressure within a muscle compartment leads to inadequate blood supply to the tissues inside the compartment. It's rare but could be a cause of severe thigh pain, especially after intense exercise or trauma.
- Nerve entrapment syndromes (e.g., femoral nerve entrapment): These conditions involve compression of nerves and could cause pain, numbness, or weakness in the distribution of the affected nerve. They are less common causes of thigh pain on hip flexion.