Differential Diagnosis for Sharp Pain in Upper Hip
The patient presents with a sharp pain in the upper hip along the hip bone line, exacerbated by movement or prolonged sitting. The following differential diagnosis is organized into categories:
- Single Most Likely Diagnosis + Trochanteric bursitis: This condition is characterized by inflammation of the bursae surrounding the greater trochanter, leading to pain and tenderness in the upper hip. The pain is often exacerbated by movement, sitting, or lying on the affected side, making it a likely diagnosis given the patient's symptoms.
- Other Likely Diagnoses + Gluteus medius tendonitis: Inflammation or strain of the gluteus medius tendon can cause pain in the upper hip, particularly with movement or weight-bearing activities. + Iliotibial (IT) band syndrome: Friction or inflammation of the IT band as it passes over the greater trochanter can cause pain in the upper hip, often exacerbated by running, cycling, or other repetitive activities. + Osteoarthritis of the hip: Degenerative joint disease can cause pain in the hip, particularly with weight-bearing activities or prolonged sitting.
- Do Not Miss Diagnoses + Avulsion fracture: A fracture of the greater trochanter or surrounding bone can cause severe pain and should not be missed, as it may require surgical intervention. + Stress fracture: A stress fracture of the femur or pelvis can cause pain in the upper hip, particularly with weight-bearing activities. + Bone tumor or metastasis: Although rare, a bone tumor or metastasis can cause pain in the hip and should be considered in the differential diagnosis, especially if the patient has a history of cancer.
- Rare Diagnoses + Greater trochanteric pain syndrome (GTPS): A condition characterized by pain and tenderness over the greater trochanter, often associated with gluteus medius tendonitis or trochanteric bursitis. + Piriformis syndrome: Compression of the sciatic nerve by the piriformis muscle can cause pain in the hip and buttock, although it is less likely to cause pain specifically along the hip bone line.