Radiography: Can show ossified or osteochondral loose bodies Limited ROM, catching and grinding with provocative maneuvers, positive FADIR and FABER tests Mechanical symptoms, history of hip dislocation or low-energy trauma, history of Legg-Calvé-Perthes disease Radiography: Early small femoral epiphysis, sclerosis and flattening of the femoral head Ultrasonography: Tendinopathy, bursitis, fluid around tendonĭynamic ultrasonography: Snapping of iliopsoas or iliotibial band over greater trochanter MRI: Bursitis and edema of the iliotibial band Snap with FABER to extension, adduction, and internal rotation reproduction of snapping with extension of hip from flexed position Iliopsoas bursitis (internal snapping hip)ĭeep, referred pain intermittent catching, snapping, or popping Magnetic resonance arthrography: offers added sensitivity and specificity Trendelenburg or antalgic gait, loss of internal rotation, positive FADIR and FABER tests Mechanical symptoms, such as catching or painful clicking history of hip dislocation Radiography: Cam or pincer deformity, acetabular retroversion, coxa profundaĭull or sharp, referred pain pain with weight bearing Painful ROM, pain on palpation of greater trochanterĭeep, referred pain pain with standing after prolonged sitting MRI: Can show tear or detachment of the rectus abdominis or adductor longusĪnterolateral hip and groin pain (C sign)ĭeep, referred pain pain with weight bearingįemales (especially with female athlete triad), endurance athletes, low aerobic fitness, steroid use, smokers

No hernia, tenderness of the inguinal canal or pubic tubercle, adductor origin, pain with resisted sit-up or hip flexion Obesity, pregnancy, tight pants or belt, conditions with increased intra-abdominal pressureĭull, diffuse pain radiating to inner thigh pain with direct pressure, sneezing, sit-ups, kicking, Valsalva maneuver Magnetic resonance arthrography is the diagnostic test of choice for labral tears. Magnetic resonance imaging is valuable for the detection of occult traumatic fractures, stress fractures, and osteonecrosis of the femoral head. Magnetic resonance imaging should be performed if the history and plain radiograph results are not diagnostic. Initial plain radiography of the hip should include an anteroposterior view of the pelvis and frog-leg lateral view of the symptomatic hip. Radiography should be performed if acute fracture, dislocations, or stress fractures are suspected. Clinical examination tests, although helpful, are not highly sensitive or specific for most diagnoses however, a rational approach to the hip examination can be used. Lateral hip pain occurs with greater trochanteric pain syndrome. Posterior hip pain is associated with piriformis syndrome, sacroiliac joint dysfunction, lumbar radiculopathy, and less commonly ischiofemoral impingement and vascular claudication. Anterior hip and groin pain is commonly associated with intra-articular pathology, such as osteoarthritis and hip labral tears. Patients often express that their hip pain is localized to one of three anatomic regions: the anterior hip and groin, the posterior hip and buttock, or the lateral hip. The differential diagnosis of hip pain is broad, presenting a diagnostic challenge. Hip pain is a common and disabling condition that affects patients of all ages.

Normal hip spine xrays