Diagnosing Young Adults with Hip Pain an Approach

Visual summary Diagnosing young adults with hip pain

Suggests severe Hip pain in young adults can be severe and disabling, affecting work, parenting, Intra-articular symptoms and leisure activities. It can be difficult to differentiate between the different causes Urgent referral or of intra-articular hip pain based on clinical assessment alone. imaging required Extra-articular A targeted history and examination can help ascertain whether a patient’s symptoms Non-orthopaedic are likely coming from the hip joint itself or from elsewhere.

Examination can be normal in early stages Specific injury Person engaged Stress fracture to the hip Person unable in occupational or to bear weight sporting activities with Risk factors a recent increase in Female sex weight bearing Older age at activity menarche Avascular necrosis Acute of femoral head fracture Risk factors Alcohol excess Tenderness to Steroid use Infection deep palpation in femoral Hypercoagulable state neck region

Pain preventing Tumours sleep at night

Pain in other History of joints or Osteoarthritis childhood hip constitutional Inflammatory problems, such as: symptoms arthritis Developmental dysplasia of hip Slipped capital femoral epiphysis Lateral Locking, hip/thigh popping, or Perthes’ disease Snapping hip pain grinding in syndromes Snapping or the hip clunking sensation Risk factors in and around hip Dancing or other joint extreme hip motion Pain on sitting Femoroacetabular for extended impingement periods

Bursitis or gluteal Risk factors tendinopathy Childhood SCFE

Risk factors Intense sporting Middle aged activity in childhood or adolescence Adult Female (controversial) acetabular Tenderness dysplasia to palpation over greater trochanter Patient indicates pain location Flex hip to 90°, gentle using C-sign or Positive adduction and internal rotation coordinate impingement fingers test Test is positive if it reproduces patient’s typical pain

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