Differential Diagnosis for Painful Skin Sensation on Right Hip

Single Most Likely Diagnosis

• Meralgia Paresthetica: A condition characterized by numbness, tingling, and burning pain in the outer thigh, caused by compression of the lateral femoral cutaneous nerve. The absence of deep pain in the hip and the location of the pain on the right hip make this diagnosis the most likely.

Other Likely Diagnoses

• Trochanteric Bursitis: Inflammation of the bursa over the greater trochanter of the femur, which can cause pain and tenderness over the lateral aspect of the hip. The pain is usually localized to the area over the trochanter and may radiate down the thigh.
• Piriformis Syndrome: A condition where the piriformis muscle compresses the sciatic nerve, causing pain, numbness, and tingling in the buttocks and thigh. However, this typically involves deeper pain and radiation down the leg, which may not perfectly match the described symptoms.
• Cellulitis or Skin Infection: An infection of the skin and subcutaneous tissues, which can cause pain, redness, and swelling. The absence of deep pain in the hip suggests a superficial process.

Do Not Miss Diagnoses

• Osteonecrosis of the Femoral Head: Although the patient reports no deep pain, early stages of osteonecrosis might present with subtle symptoms. Missing this diagnosis could lead to significant morbidity if not addressed promptly.
• Metastatic Bone Disease: Cancer that has spread to the bone can cause a variety of symptoms, including pain. While less likely given the superficial nature of the pain, it's crucial not to miss this diagnosis due to its severe implications.
• Deep Vein Thrombosis (DVT): Although DVT typically presents with swelling, warmth, and discoloration of the leg, in some cases, it might cause pain without these classic signs. Given the potential for severe consequences if untreated, DVT should be considered.

Rare Diagnoses

• Erythromelalgia: A rare disorder characterized by burning pain, heat, and redness in the hands and feet, and sometimes the hips. It's an uncommon condition but could be considered if other diagnoses are ruled out.
• Complex Regional Pain Syndrome (CRPS): A chronic pain condition that most often affects one of the arms, legs, hands, or feet after an injury or trauma. While rare, CRPS could present with a variety of pain patterns, including superficial pain in the hip area.