Differential Diagnosis for Hip Pain after Long Standing without Trauma
Single Most Likely Diagnosis
- Osteoarthritis: This is the most common cause of hip pain in adults, especially after prolonged standing or walking. The lack of trauma and the gradual onset of pain point towards a degenerative condition like osteoarthritis.
Other Likely Diagnoses
- Trochanteric Bursitis: Inflammation of the bursa over the trochanter can cause hip pain, especially when standing or walking for long periods. This condition is common and can be related to repetitive strain or poor biomechanics.
- Piriformis Syndrome: The piriformis muscle can irritate the sciatic nerve, leading to hip and buttock pain, which may worsen with prolonged standing or walking.
- Hip Flexor Strain: Overuse or strain of the hip flexor muscles can cause pain in the hip area, particularly after activities that involve long periods of standing.
Do Not Miss Diagnoses
- Avascular Necrosis: Although less common, avascular necrosis of the femoral head can cause hip pain without a history of trauma, especially in individuals with risk factors such as long-term steroid use or excessive alcohol consumption. Missing this diagnosis can lead to severe consequences, including collapse of the femoral head.
- Infection (Septic Arthritis): While rare, hip pain could be a sign of septic arthritis, an infection within the joint space. This condition is a medical emergency requiring prompt diagnosis and treatment to prevent serious complications.
- Malignancy: Tumors, either primary or metastatic, can cause hip pain. Although rare, missing a diagnosis of malignancy can have devastating consequences, making it crucial to consider in the differential diagnosis.
Rare Diagnoses
- Femoroacetabular Impingement (FAI): A condition where there is abnormal contact between the femoral head and the acetabulum, leading to pain and limited mobility. It's less common than osteoarthritis but can cause significant symptoms.
- Synovial Chondromatosis: A rare condition characterized by the growth of cartilage in the synovial membrane of the joint, leading to pain, swelling, and decreased mobility.
- Paget's Disease of Bone: A chronic bone disorder that can cause enlarged and misshapen bones, leading to pain and other complications. It's rare and usually affects older adults.