Differential Diagnosis for Hip Pain
Single most likely diagnosis
- Osteoarthritis of the hip: This is the most common cause of hip pain that worsens with standing and ambulation, and improves with rest. The chronic nature of the pain and its relation to weight-bearing activities support this diagnosis.
Other Likely diagnoses
- Trochanteric bursitis: Inflammation of the bursa over the trochanter can cause hip pain, especially when standing or walking. This condition is common and can be related to repetitive motion or direct trauma.
- Labral tear: A tear in the labrum, the cartilage that surrounds the socket of the hip joint, can cause pain with weight-bearing activities. This condition is more common in younger, active individuals.
- Stress fracture: A fracture in one of the bones around the hip joint can cause pain with standing and walking. This is more common in individuals with osteoporosis or those who have recently increased their physical activity.
Do Not Miss diagnoses
- Avascular necrosis: This condition, where the blood supply to the bone is disrupted, can cause hip pain and is often associated with weight-bearing activities. It is crucial to diagnose early to prevent further damage.
- Infection (septic arthritis): An infection in the hip joint can cause severe pain, especially with movement. This is a medical emergency that requires prompt diagnosis and treatment.
- Malignancy (bone tumor): Although rare, a tumor in the bone around the hip joint can cause pain with standing and walking. It is essential to consider this possibility, especially if the pain is persistent and worsening.
Rare diagnoses
- Piriformis syndrome: Compression of the sciatic nerve by the piriformis muscle can cause hip and buttock pain, which may worsen with standing and walking.
- Slipped capital femoral epiphysis (SCFE): A condition where the ball at the upper end of the femur (thigh bone) slips out of place, more common in adolescents. It can cause hip pain that worsens with weight-bearing activities.
- Osteonecrosis of the femoral head: Similar to avascular necrosis, but often used to describe the condition in specific contexts, such as post-traumatic or steroid-induced.