Differential Diagnosis for Medial Thigh Pain Radiating to Hip

Single Most Likely Diagnosis

• Obturator Nerve Entrapment: This condition is the most likely cause of medial thigh pain that radiates up to the hip. The obturator nerve originates from the lumbar plexus and runs through the obturator canal, supplying the adductor muscles of the thigh. Entrapment or compression of this nerve can cause pain in the medial thigh and hip area.

Other Likely Diagnoses

• Meralgia Paresthetica: This condition involves compression of the lateral femoral cutaneous nerve, which can cause pain, numbness, and tingling in the thigh. However, it typically affects the lateral aspect of the thigh. In some cases, the pain can radiate to the hip and medial thigh.
• Lumbar Radiculopathy (L2-L4): Irritation or compression of the lumbar nerve roots (L2-L4) can cause pain that radiates to the medial thigh and hip. This is due to the nerve roots' contribution to the lumbar plexus, which gives rise to the obturator nerve.
• Piriformis Syndrome: Although piriformis syndrome typically causes pain in the buttock and posterior thigh, in some cases, the pain can radiate to the hip and medial thigh, especially if the piriformis muscle compresses nearby nerves.

Do Not Miss Diagnoses

• Hip Fracture or Osteonecrosis: These conditions can cause hip pain that radiates to the medial thigh. It is crucial to rule out these diagnoses, as they require prompt medical attention to prevent further complications.
• Abdominal or Pelvic Pathology (e.g., Appendicitis, Diverticulitis): In rare cases, abdominal or pelvic conditions can cause referred pain to the medial thigh and hip. These conditions can be life-threatening if not diagnosed and treated promptly.
• Spinal Stenosis or Cauda Equina Syndrome: These conditions can cause pain, numbness, and weakness in the lower extremities, including the medial thigh. They require urgent medical attention to prevent permanent neurological damage.

Rare Diagnoses

• Neoplastic or Infectious Processes (e.g., Tumors, Abscesses): Rarely, neoplastic or infectious processes can cause medial thigh pain that radiates to the hip. These conditions often have additional symptoms, such as weight loss, fever, or a palpable mass.
• Vasculitis or Arteritis: Inflammatory conditions affecting the blood vessels, such as vasculitis or arteritis, can cause pain in the medial thigh and hip. These conditions often have systemic symptoms, such as fever, fatigue, and weight loss.