What is hip joint pain?
There are many hip pain causes. The range of causes include broken bones to arthritis. Inflammation from an injury or infection is also a consideration.
Quickcare or ER?
The Red Flags that will send you to the ER include:
- Infection in the hip
- Inability to walk
- Severe Pain
Pain is great indicator that “something is wrong”
What will your doctor ask ?
A doctor will want to know your symptoms……
Remember, a symptom is your description of your condition to your doctor. It is your story
How long have you had the pain?
Where exactly is it?
What makes it better?
What makes it worse?
Did you fall?
What will your doctor look for
Your doctor will look for signs.
Remember, signs are objective findings that a doctor finds on examination
A doctor will look for a few things….Is Grandma able to walk?
Is she running a fever?
On the exam table, a doctor will look for a range of motion of the hip. That is, movement up, back and inside/outside.
Also, is one leg shorter than the other when your patient is lying down? A shortened leg is indicative of a hip fracture.
What is your doctor thinking?
Your doctor is thinking of differential diagnosis. In a nutshell, he or she is trying to think of the possible cause for hip pain
Even though your patient did not have a fall, a doctor still needs to think of a broken bone. Sports injuries causing hip pain include stress fractures at the femoral neck. At an older age , the smallest breaks can be present. It would be good to find a fracture sooner rather than later.
If a fever is present, I would consider an infection in the joint.
Hip bursitis is another diagnosis to consider when hip pain is present. Arthritis is another consideration. Chronic hip pain may be due to a nerve inflammation.
With children who have hip pain, your doctor should consider Slipped Capital Femoral Epiphysis or Leg-Calve-Perthes. If a fever is also present, septic arthritis due to a bacteria needs to be explored. A viral infection may cause toxic synovitis in children ages 3-8 years old. Another consideration is a development abnormality.
What is the treatment of hip pain?
If there is no broken bone or fever, then simple anti-inflamatories are ok.
Be careful! If your patient cannot walk, then there has to be a high index of suspicion for a broken bone. At that point, both xrays and even an MRI are reasonable.
A CT can be done if MRI is not available.
If your patient cannot walk, he or she will probably spend the night in the hospital for their own protection.
Besides an xray, an ultrasound can be used to look for a fluid collection at the joint. Ultrasound also is useful to determine if a hernia is present.
With children, a bone scan is beneficial with children who have a non-specific limp or hip pain.
How long will you be sick?
This is difficult one to answer. A broken bone may take weeks or months to heal up. An infection is serious and needs antibiotics and possibly surgical drainage.
Even if these other bad things are not present, the pain may be chronic (meaning weeks or months)
Let me tell you a story…….
There once was very pleasant lady who had hip pain. She never did have kids of her own but everyone on the street knew her as “Grandma.” Through the years of babysitting, she raised nearly everyone around her.
She was a tough ol’ bird but golly Moses, she could not take the pain on her hip any more. She knew there a problem when she could not run; Couldn’t golf; couldn’t dance. Could not even get off the toilet.
In the case of Grandma, her pain was local, severe, worse with walking. No associated fever or swelling.
I hope this helps