IDENTIFYING THE CAUSE OF YOUR PAIN

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LOCATION OF THE PAIN

Pain arising from the hip, is usually felt within the groin. It can also be felt around trochanter which is the bony prominence you can feel at the top of your thigh bone. Less commonly it can be felt in the buttock. Hip pain can radiate down the thigh usually to the level of the knee. Back pain and hip pain can overlap. Through a combination of careful history taking, examination and investigations, the source of your pain will be identified. Diagnostic injections can also be helpful to localise the pain. 

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LAYERS OF THE HIP

The hip is made of various layers, and pain can arise from any of these. The innermost layer is the bone and cartilage that lines the hip. Arthritis affects this layer and is a result of damage to the cartilage. This is the lining of the joint that normally allows the joint to move smoothly. The capsule and labrum forms a surrounding bag around the joint and keeps lubricating fluid in the joint. Sports injuries and impingement of bone can cause damage to this layer. The surrounding nerves and muscles can also cause pain and back pain can also radiate around to the hip. 

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CAUSES OF HIP PAIN

Mechanical causes of hip pain include dysplasia and femoroacetabular impingement (FAI). Dysplasia is caused by a shallow hip socket, This means the hip ball is not fully covered by the socket and this can increase the pressure on the edge of the socket leading to pain and damage initially to the edge of the socket. FAI results from excess bone either on the edge of the socket or on the ball. This mismatch between the ball and socket causes abnormal contact and can also cause damage initially starting at the edge of the socket. If the damage continues then both dysplasia and FAI can cause damage to the rest of the cartilage of the hip resulting in arthritis. Other causes of arthritis include trauma, avascular necrosis (interruption of the blood supply to the hip ball) and inflammation. 

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INVESTIGATIONS

We will usually start with xrays of your hips. This can help identify problems such as arthritis, dysplasia and femoroacetabular impingement. Further tests with MRI or CT scans may then be required depending on what the suspected problem is. If you had any investigations done elsewhere then please do let us know so we can try and import the images onto our systems. 

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