Hip History
  • Age and sex
    • Ages 4-10 have higher indidence of transient synovitis, Legg-Calve-Perthes disease, and juvenile rheumatoid arthritis
    • Apophyseal injuries and avulsion fractures of the pelvis can occur in young athletes (Patella 1995)
    • Epiphysolysis: most often affects adolescent girls 11-13 and adolescent boys 13-15 years
    • Articular osteochontritis dissecans most common between 15-25 years
    • Ischemic femoral necrosis and synovial osteochondromatosis typically affects those between 35 and 50 years
    • Labral Lesions usually affect those 18-40 years
    • Labral cysts, sacral pathologies, and stress fractures of the femur or pelvis usually occur in those over 40 years
    • Stress fractures in the proximal femur may also occur in young females, especially those with the female triad (eating disorder, dysmenorheal, and osteoporosis)
    • Elderly women are more prone to osteoporotic femoral neck fractures
  • Patient complains of clicking in the hip
    • For detection of labral pathology (Narvani et al 2003)
      • Sn=1
      • Sp=.85
      • +LR=6.67
      • -LR=0
  • Location of pain (These conditions may refer to multiple areas)
    • Groin: labrum, symphysis pubis lesions, adductor tendopathy, iliopectineal bursitis, incompetent abdominal wall, or other urological, gynecological, neurovascular, or organic lesions
    • Buttock: SIJ dysfunction, gluteal bursitis, hamstring tendopathy, hamstring syndrome, lumbar spine affliction, lumbosacral nerve roots
    • Posterolateral: trochanteric bursitis, gluteal insertion tendopathy or disruption, THA component loosening, lumbar spine
  • Increased pain with coughing, sneezing, or straining
    • Consider hernia, pubic symphyseal affliction, tendopathy of the adductor longus or rectus abdominus in located anteriorly
    • Consider lumar nerve roots if located posteriorly in the buttock or down the posterior leg
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