Q&A on Hip Joint Pain

There are many hip diseases that could be causing hip joint pain. Diagnosing the cause of the hip joint pain based on the signs and symptoms is vital for early and successful recovery.

Causes of Hip Joint Instability

What Can Cause Hip Joint Pain?

Medical Conditions that can cause hip joint pain includes:

What are the Symptoms and Signs of Hip Joint Pain?

Symptoms of hip joint diseases are either specific or nonspecific. Specific symptoms are localized over the hip joint or same side extremity.

Symptoms of Hip Joint Pain

Specific Symptoms Of Hip Joint Pain

  • Hip joint Pain.
  • Hip Joint Weakness.
  • Hip Joint Instability.
  • Hip Joint Stiffness.
  • Restricted Hip Joint Movement.
  • Hip Joint Tenderness.
  • Hip Joint Deformity.
  • Hip Joint Swelling.
  • Hip Joint Crunching Sound.
  • Limping During Ambulation.
  • Fever With Hip Joint Tenderness and Swelling.

Nonspecific Symptoms Of Hip Joint Pain

  • Obesity
  • Fatigue
  • Weakness
  • Loss of Appetite

What Is The Importance of Specific Symptoms in Diagnosing Hip Joint Pain?

Knowing the specific symptoms contribute in diagnosis of specific cause of hip joint disease. Specific symptom often points the origin of cause of the hip joint disease. Further image or lab study is necessary to establish the diagnosis of hip joint pain.

Specific symptom like patient is unable to stand or walk while using painful leg indicates patient may be suffering with severe arthritis, dislocation or fracture of the hip joint. Image study like X-ray, CAT scan or MRI will differentiate the real cause of the pain.

What Is The Significance of Nonspecific Symptoms in Diagnosing Hip Joint Pain?

Nonspecific symptoms are observed in few of the hip joint diseases. Nonspecific symptoms do not help in diagnosis of specific causes of hip joint disease. Symptoms such as loss of weight, fatigue and dehydration may suggest underlying hip joint cancer or infection as the cause of pain. Nonspecific symptoms without hip joint pain may be present in several systemic diseases unrelated to hip joint.

Classification of Hip Joint Pain

Hip joint pain is a specific symptom observed in most of the hip joint diseases. Hip joint pain is classified based on its duration and intensity -

Duration of Hip Joint Pain

  • Acute Hip Joint Pain- Acute hip Joint pain is caused by trauma resulting in soft tissue sprain or tear, and fracture or dislocation. Acute hip joint pain lasts for 3 to 6 months.
  • Chronic Hip Joint Pain- Continuous hip joint pain for over 6 months is known as chronic pain. Chronic hip joint pain caused by arthritis is often periodic. Patient may experience good and bad months. Chronic hip joint pain caused by hip joint dislocation, hip joint fracture, avascular necrosis and postsurgical trauma are often continuous and severe. Such chronic intense hip joint pain is difficult to treat with conservative therapy such as medications and physical therapy.

Intensity of Hip Joint Pain

Hip Joint Pain is measured as Visual Analogue Score (VAS). Score of zero VAS is no pain and score of 10 VAS is most severe pain. Intensity of hip joint pain is measured as follows-

  • For Mild Hip Joint Pain-Visual Analogue score of pain (VAS) is zero to 2.5,
  • For Moderate Hip Joint Pain - VAS of 2.5 to 5,
  • For Severe Hip Joint Pain - VAS of 5 to 7.5
  • For Very Severe Hip Joint Pain - VAS of 7.5 to 10.

Describe The Anatomical Sites Where Hip Joint Pain Is Detected?

Hip joint pain is referred or felt at following dermatome or sites.

  • Thigh- Often mistaken for pinched nerve pain or radicular pain.
  • Groin- Mistaken for inguinal hernia.
  • Lateral Side of the Hip Joint- Mistaken for facet joint pain.
  • Buttocks- Misdiagnosed as facet joint or sacroiliac joint pain.

How is the Diagnosis of Hip Joint Pain Done?

Diagnosing the Cause of Hip Joint Pain When Accompanied With Leg Weakness

Hip joint pain caused by arthritis, tendinitis and bursitis restricts the movement of the hip joint and leg on same side. Restricted muscle activities of the leg results in decrease of power and tone of the muscles causing weakness of the leg on same side. Muscle weakness may be secondary to nerve damage or lesion. Rarely peripheral nerve damage may be associated with fracture or dislocation of the hip joint.

Muscle Weakness May Be Observed In Following Hip Joint Diseases

  • Hip Joint Arthritis.
  • Hip Joint Bursitis.
  • Hip Joint Tendinitis.
  • Hip Joint Dislocation.
  • Hip Joint Fracture.

Diagnosing the Cause of Hip Joint Pain When Accompanied With Leg Instability

Diagnosing The Cause Of Hip Joint Stiffness

Instability of lower extremity is seen in following hip joint diseases. Instability of legs is often seen during standing and walking. Instability of legs results from difficulty to stand or ambulate using diseased leg. Instability of lower extremities is observed during certain posture and weight bearing, which may cause sudden intense pain in legs. Sudden intense leg pain is observed in patients suffering with hip joint tendinitis, hip joint tendon rupture, avascular necrosis and severe hip joint arthritis. Sudden intense pain often results during ambulation or change of position from sitting to standing or lying down to sitting. Sudden intense pain abruptly stops the forward or any movement of the leg and results in instability or fall. Rarely instability of lower extremity is also observed secondary to nerve lesion and muscle weakness. Instability of hip joint and leg is common symptom following dislocation or fracture of the hip joint.

Causes of Hip Joint Instability and Leg Instability Are As Follows

  • Hip Tendinitis
  • Hip Arthritis
  • Avascular Necrosis
  • Hip Joint Dislocation
  • Hip Joint Fracture
  • Hip Labral Tear

Diagnosing the Cause of Hip Joint Pain When Accompanied With Hip Joint Stiffness

Hip joint stiffness causes restricted movements of the joint. Joint stiffness is also seen following muscle atrophy and ligamental tear. Scarring of tendon or muscles after soft tissue lesion or injury occasionally causes hip joint stiffness. Following hip joint diseases can cause hip joint stiffness:

Following Hip Joint Diseases Causes Hip Joint Stiffness:

  • Hip Joint Sprain
  • Hip Tendinitis
  • Hip Arthritis
  • Avascular Necrosis
  • Hip Joint Dislocation
  • Hip Joint Fracture
  • Hip Labral Tear

Diagnosing the Cause of Hip Joint Pain When Accompanied With Restricted Hip Joint Movements

Restricted hip joint movement is often seen secondary to subluxation, fracture or dislocation of hip joint. Restriction of the joint movement is secondary to head of the femur unable to move over the acetabulum. Restriction is also observed in patients suffering with advanced arthritis and tear of tendon. Rarely patient suffering with tendinitis and advanced arthritis may present with signs of spasticity and restricted hip joint movements.

Following Hip Joint Diseases Causes Hip Joint Restriction:

  • Hip Tendinitis
  • Hip Arthritis
  • Hip Joint Dislocation
  • Hip Joint Fracture
  • Hip Labral Tear

Diagnoses of Hip Joint Pain When Accompanied With Hip Joint Tenderness

Hip joint tenderness is a symptom of moderate to severe pain often observed during examination of hip joint. Examination hip joint is either palpation or deep pressure over the joint. Tenderness is secondary to inflammation of the soft tissue like tendon, ligament and muscles. Tenderness is also seen in patients suffering with dislocation or fracture of hip joint.

Following Hip Joint Diseases Causes of Hip Joint Tenderness:

  • Hip Bursitis
  • Hip Tendinitis
  • Hip Arthritis
  • Avascular Necrosis
  • Hip Joint Dislocation
  • Hip Joint Fracture
  • Hip Labral Tear

Diagnosing the Cause of Hip Joint Pain When Accompanied With Hip Joint Deformity

Hip joint is a ball and socket joint. Subluxation and dislocation of hip joint changes the alignment of head of the femur (ball shape) and acetabulum of pelvis (socket). Dislodged head of the femur from socket protrude through muscles and skin showing joint deformity on examination. Hip joint deformity is also observed in fracture of hip joint. Fractured neck femur maintains the position of head of the femur in acetabulum socket but the exposed end of fracture protrudes through the muscles, tendons and skin showing joint deformity. Protrusion caused by Joint deformity is firm in consistency on examination and palpation.

Following Hip Conditions Are Associated With Hip Joint Deformity:

  • Hip Arthritis (subluxation)
  • Hip Joint Dislocation
  • Hip Joint Fracture
  • Hip Labral Tear

Diagnosing the Cause of Hip Joint Pain When Accompanied With Hip Joint Swelling

Hip joint swelling is soft or firm and tender. Causes of swelling is inflammation of the joint and results in swelling of synovial membrane, ligaments and tendons. Soft and tender hip joint swelling is secondary to bleeding (hematoma) around the joint and abscess of the soft tissue surrounding the joint.

  • Hip Arthritis
  • Avascular Necrosis
  • Hip Joint Abscess
  • Hip Labral Tear

Diagnosing the Cause of Hip Joint Pain When Accompanied With Crunching Sounds

Crunching sound is often heard when bone is rubbing against each other as in following diseases.

Hip Joint Diseases That Can Cause Crunching Sounds

  • Hip Joint Dislocation
  • Hip Joint Fracture

Diagnosing the Cause of Hip Joint Pain When Accompanied With Limping

Limping is often seen when patient cannot stand on the affected leg because of pain. Limping is often seen as restricted abrupt cessation of flexion and extension while changing position or walking.

Limping Is Seen In Following Hip Joint Diseases

  • Hip Tendinitis
  • Hip Arthritis
  • Avascular Necrosis
  • Hip Joint Dislocation
  • Hip Joint Fracture
  • Hip Labral Tear.

Also Read:

Written, Edited or Reviewed By:

, MD, FFARCSI

Last Modified On: September 13, 2016

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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