Hip Pain Differential Diagnosis
The differential diagnosis for hip pain can be organized into the following categories:
- Single Most Likely Diagnosis
- Osteoarthritis: This is the most common cause of hip pain in older adults, characterized by wear and tear of the joint cartilage, leading to pain, stiffness, and limited mobility. The likelihood of osteoarthritis increases with age, obesity, and previous hip injuries.
- Other Likely Diagnoses
- Trochanteric bursitis: Inflammation of the bursa over the trochanter, often caused by repetitive friction or direct trauma, leading to pain and tenderness on the outer aspect of the hip.
- Hip fractures: Common in older adults, especially those with osteoporosis, hip fractures can cause severe hip pain, especially after a fall.
- Piriformis syndrome: Compression of the sciatic nerve by the piriformis muscle, leading to pain, numbness, and tingling in the buttock and leg.
- Labral tears: Tears in the cartilage surrounding the hip socket, often caused by trauma, overuse, or degenerative changes, leading to hip pain and limited mobility.
- Do Not Miss Diagnoses
- Septic arthritis: A bacterial infection of the joint, which can lead to severe pain, swelling, and systemic symptoms, requiring prompt antibiotic treatment to prevent joint destruction.
- Avascular necrosis: Death of bone tissue due to lack of blood supply, often caused by trauma, steroids, or excessive alcohol consumption, leading to hip pain and collapse of the bone.
- Slipped capital femoral epiphysis (SCFE): A condition in which the ball at the upper end of the femur slips out of place, often caused by obesity or hormonal imbalances, leading to hip pain and limited mobility.
- Rare Diagnoses
- Synovial chondromatosis: A rare condition characterized by the growth of cartilage in the joint, leading to hip pain, swelling, and limited mobility.
- Pigmented villonodular synovitis (PVNS): A rare condition characterized by the growth of abnormal tissue in the joint, leading to hip pain, swelling, and limited mobility.
- Osteonecrosis of the femoral head: A rare condition characterized by the death of bone tissue in the femoral head, often caused by trauma, steroids, or excessive alcohol consumption, leading to hip pain and collapse of the bone.