Differential Diagnosis for Severe Hip Pain

The following differential diagnosis is organized into categories to help guide the thought process:

• Single Most Likely Diagnosis
  • Osteoarthritis of the Hip: This is a common condition that causes hip pain, especially in older adults. The "catching" sensation when bending over could be due to bone-on-bone contact or loose fragments in the joint.
• Other Likely Diagnoses
  • Trochanteric Bursitis: Inflammation of the bursa over the trochanter can cause severe hip pain, especially when bending or lying on the affected side.
  • Piriformis Syndrome: Irritation of the piriformis muscle can cause hip pain that worsens with bending or sitting.
  • Labral Tear: A tear in the cartilage surrounding the hip joint can cause a catching sensation and severe pain, especially with hip flexion.
• Do Not Miss Diagnoses
  • Septic Arthritis: A bacterial infection in the hip joint can cause severe pain, swelling, and limited mobility. This condition requires prompt medical attention to prevent joint destruction.
  • Avascular Necrosis: Disruption of blood supply to the hip joint can cause severe pain and lead to joint collapse if left untreated.
  • Fracture: A hip fracture can cause severe pain, especially with weight-bearing or movement.
• Rare Diagnoses
  • Synovial Chondromatosis: A rare condition where cartilage grows in the joint, causing pain, swelling, and limited mobility.
  • Intra-Articular Tumor: A rare tumor within the hip joint can cause pain, swelling, and limited mobility.
  • Slipped Capital Femoral Epiphysis (SCFE): A rare condition where the femoral head slips out of place, causing severe hip pain, especially in adolescents.