Differential Diagnosis of Hip Pain

The differential diagnosis of hip pain is broad and can be categorized into several groups. Here's a breakdown of the possible causes:

• 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.
  • Tendinitis: Inflammation of the tendons surrounding the hip joint, commonly affecting the gluteus medius or minimus tendons, leading to pain and weakness.
  • Labral Tears: Tears in the cartilage surrounding the socket of the hip joint, often caused by trauma, overuse, or degenerative changes, leading to pain, catching, or locking sensations.
  • Stress Fractures: Small cracks in the bone, often occurring in athletes or individuals with osteoporosis, leading to pain and tenderness.

• Do Not Miss Diagnoses

  • Septic Arthritis: A bacterial infection within the joint, requiring prompt antibiotic treatment to prevent long-term damage and disability.
  • Avascular Necrosis: Death of bone tissue due to lack of blood supply, often caused by trauma, steroids, or excessive alcohol consumption, leading to pain and collapse of the bone.
  • Slipped Capital Femoral Epiphysis (SCFE): A condition in adolescents where the ball at the upper end of the femur slips out of place, requiring urgent treatment to prevent long-term damage.

• Rare Diagnoses

  • Piriformis Syndrome: Compression of the sciatic nerve by the piriformis muscle, leading to pain, numbness, and tingling in the buttock and leg.
  • Osteonecrosis: Death of bone tissue due to various causes, including trauma, infection, or vascular disease, leading to pain and collapse of the bone.
  • Synovial Chondromatosis: A rare condition where cartilage grows within the joint, leading to pain, stiffness, and limited mobility.