Hip Pain in Adults

Key points

• Osteoarthritis: pain exacerbated by exercise and relieved by rest; reduced internal rotation is often the first sign
• Inflammatory arthritis: pain and stiffness worse in the morning, improving with activity
• Referred lumbar spine pain: may present as buttock/posterior thigh pain; hip examination and range of movement are typically normal
• Greater trochanteric pain syndrome (trochanteric bursitis): lateral hip pain, tender over the greater trochanter, common in women aged 50–70
• Meralgia paraesthetica: due to compression of the lateral cutaneous nerve of the thigh, causing burning/tingling over the antero-lateral thigh
• Avascular necrosis: may present with groin pain and restricted range of movement; risk factors include steroid use and alcohol excess
• Pubic symphysis dysfunction: common in pregnancy, causing pain over the pubic symphysis radiating to the groin and medial thigh
• Transient idiopathic osteoporosis: usually seen in the third trimester of pregnancy, causing groin pain and limited hip range of movement