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afya HipPainInAdults

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20160425222458 Ben  
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''Osteoarthritis''
	Pain exacerbated by exercise and relieved by rest
Reduction in internal rotation is often the first sign
Age, obesity and previous joint problems are risk factors

''Inflammatory arthritis''
	Pain in the morning
Systemic features
Raised inflammatory markers

''Referred lumbar spine pain''	
Femoral nerve compression may cause referred pain in the hip
Femoral nerve stretch test may be positive - lie the patient prone. Extend the hip joint with a straight leg then bend the knee. This stretches the femoral nerve and will cause pain if it is trapped

''Greater trochanteric pain syndrome (Trochanteric bursitis)''	
Due to repeated movement of the fibroelastic iliotibial band
Pain and tenderness over the lateral side of thigh
Most common in women aged 50-70 years

''Meralgia paraesthetica''	
Caused by compression of lateral cutaneous nerve of thigh
Typically burning sensation over antero-lateral aspect of thigh

''Avascular necrosis''	
Symptoms may be of gradual or sudden onset
May follow high dose steroid therapy or previous hip fracture of dislocation

''Pubic symphysis dysfunction''	
Common in pregnancy
Ligament laxity increases in response to hormonal changes of pregnancy
Pain over the pubic symphysis with radiation to the groins and the medial aspects of the thighs. A waddling gait may be seen

''Transient idiopathic osteoporosis''	
An uncommon condition sometimes seen in the third trimester of pregnancy
Groin pain associated with a limited range of movement in the hip
Patients may be unable to weight bear
ESR may be elevated