Differential Diagnosis for Left Hip Pain with Subtle Calcification in the Labrum Region

• Single most likely diagnosis:
  • Femoroacetabular Impingement (FAI) with labral calcification: This condition is characterized by abnormal contact between the femoral head and acetabulum, leading to labral tears and potential calcification. The patient's age and presentation of hip pain, along with the finding of a subtle calcification in the labrum region, make FAI a plausible diagnosis.
• Other Likely diagnoses:
  • Labral tear: A tear in the labrum, the cartilage that surrounds the socket of the hip joint, can cause hip pain and may be associated with calcification.
  • Osteoarthritis: Early stages of osteoarthritis could present with hip pain and subtle calcifications, although the presence of an intact joint on X-ray makes this less likely.
  • Synovial chondromatosis: A condition where cartilage grows in the synovium, potentially leading to calcifications within the joint.
• Do Not Miss diagnoses:
  • Avascular necrosis: Although less likely given the intact appearance of the hip on X-ray, avascular necrosis (death of bone tissue due to lack of blood supply) is a critical diagnosis not to miss due to its potential for severe and irreversible damage.
  • Infection or septic arthritis: Any sign of infection within the joint is a medical emergency requiring prompt diagnosis and treatment.
• Rare diagnoses:
  • Primary synovial osteochondromatosis: A rare condition where multiple cartilaginous nodules form within the synovial membrane of the joint, potentially leading to calcification.
  • Pigmented villonodular synovitis (PVNS): A rare disease characterized by overgrowth of the joint lining, leading to inflammation and potential calcification, although this is more commonly associated with the knee.