Differential Diagnosis for Anterior Hip Pain with Standing

• Single most likely diagnosis
  • Femoroacetabular Impingement (FAI): This condition is characterized by abnormal contact between the femoral head and the acetabulum, leading to pain, especially with activities that involve flexion and rotation of the hip, such as standing from a seated position. The anterior location of the pain is consistent with FAI, particularly the cam-type impingement.
• Other Likely diagnoses
  • Hip Flexor Strain: Strains to the hip flexor muscles, such as the iliopsoas, can cause anterior hip pain that worsens with standing or activities that involve hip flexion.
  • Osteoarthritis of the Hip: While osteoarthritis can cause more generalized hip pain, anterior pain can be prominent, especially with weight-bearing activities like standing.
  • Labral Tear: Tears in the labrum, the cartilage that surrounds the socket of the hip joint, can cause anterior hip pain, especially with weight-bearing and rotational movements.
• Do Not Miss diagnoses
  • Avascular Necrosis (AVN) of the Femoral Head: AVN can cause hip pain that may initially be anterior and worsen with standing due to the increased pressure on the affected bone. Missing this diagnosis can lead to significant morbidity due to potential collapse of the femoral head.
  • Infection (Septic Arthritis): Though less common, infection within the hip joint can cause severe pain, including anterior hip pain, and is a medical emergency requiring prompt diagnosis and treatment to prevent long-term damage.
  • Fracture: Stress fractures or other types of fractures in the femoral neck or pelvis can cause anterior hip pain that worsens with standing and weight-bearing.
• Rare diagnoses
  • Psoas Abscess: An abscess in the psoas muscle can cause anterior hip pain, fever, and other systemic symptoms. It is a rare condition but requires urgent medical attention.
  • Inflammatory Arthritis (e.g., Rheumatoid Arthritis, Ankylosing Spondylitis): These conditions can cause hip pain, including anterior pain, though they are less common causes and typically present with other systemic or joint symptoms.
  • Tumors: Both benign and malignant tumors can cause hip pain, including anterior pain, though they are rare and often present with other symptoms such as night pain or systemic symptoms.