Hip Injections

Abstract

In patients with hip pain, history and physical exam are critical to diagnosis. The location and character of hip pain, along with aggravating and alleviating factors, and the impact on ambulation can all be used to distinguish conditions affecting the bursa and other soft tissues from conditions impacting the hip joint and adjacent bones. Pathology presenting from the femoroacetabular (hip) joint typically presents with pain deep within the groin. Gradual onset of groin pain with weight bearing and improvement with rest is the hallmark of osteoarthritis of the hip joint. Differential diagnosis of acute onset of groin pain with weight bearing includes occult fracture from trauma, osteonecrosis (especially in patients with a history of high glucocorticoid use), acute synovitis, or septic arthritis. By comparison, constant pain in the anterior hip region, that is, neither aggravated by direct pressure nor repetitive flexion of the hip, suggests lower abdominal/pelvic pathology, inguinal hernia, or referred pain from L2 to L3 spinal nerve roots.