Motion or position related anterior XRay: AP view hip. If persistent pain despite Motion related clinical disorder of hip/groin pain. physiotherapy to MSK for the hip with a triad of symptoms, Aggravated sitting, sitiing cross legged. specialist physiotherapy ADVICE: clinical signs and imaging findings. May have associated back, buttock or Weight loss if appropriate. assessment. Represents symptomatic premature thigh pain. contact between the proximal femur Sometimes clicking, catching, locking, MANAGEMENT: and acetabulum. stiffness, restricted range of movement Physiotherapy to address strength, or giving way. balance and motor control. Pain on impingement tests ( passive Analgesia. flexion, adduction and internal rotation). GLUTEAL TENDINOPATHY +/- BURSITIS Mainly in people >40 Common in INVESTIGATIONS: If persistent pain despite post-menopausal women. None. physiotherapy refer to MSK for Lateral hip pain, tendon primary Pathology identified on ultrasound specialist physiotherapy cause of pain, bursa involvement Worse lying on affected side, walking, or MRI does not confirm assessment secondary. particularly upstairs and slopes, tendinopathy as pathology can be Treatment aimed at improving crossing legs. present in asymptomatic individuals. tendon function. No difficulty putting on shoes/socks. May have associated back pain. ADVICE: Pain provoked over the greater Weight loss if appropriate. trochanter on standing on one leg, the Mattress topper if pain at night. affected side for up to 30 seconds. Activity modification. Pain on flexion/adduction/external Avoid positions >90 degrees flexion rotation (FADER). and adduction i.e. high chairs Pain on resisted hip internal rotation in preferable for sitting. FADER. Avoid sitting with legs crossed. Walking poles/stick. MANAGEMENT: Physiotherapy OSTEOARTHRITIS HIP Generally >45 years of age. INVESTIGATIONS: If disabling symptoms, despite XRays: AP views hip analgesic trial and suitable for
Motion related clinical disorder of the hip with a triad of symptoms, clinical signs and imaging findings. Represents symptomatic premature contact between the proximal femur and acetabulum. Motion or position related anterior hip/groin pain. Aggravated sitting, sitiing cross legged. May have associated back, buttock or thigh pain. Sometimes clicking, catching, locking, stiffness, restricted range of movement or giving way. Pain on impingement tests ( passive flexion, adduction and internal rotation). XRay: AP view hip. ADVICE: Weight loss if appropriate. MANAGEMENT: Physiotherapy to address strength, balance and motor control. Analgesia. If persistent pain despite physiotherapy to MSK for specialist physiotherapy assessment. GLUTEAL TENDINOPATHY +/- BURSITIS Lateral hip pain, tendon primary cause of pain, bursa involvement secondary. Treatment aimed at improving tendon function. Mainly in people >40 Common in post-menopausal women. Worse lying on affected side, walking, particularly upstairs and slopes, crossing legs. No difficulty putting on shoes/socks. May have associated back pain. Pain provoked over the greater trochanter on standing on one leg, the affected side for up to 30 seconds. Pain on flexion/adduction/external rotation (FADER). Pain on resisted hip internal rotation in FADER. INVESTIGATIONS: None. Pathology identified on ultrasound or MRI does not confirm tendinopathy as pathology can be present in asymptomatic individuals. ADVICE: Weight loss if appropriate. Mattress topper if pain at night. Activity modification. Avoid positions >90 degrees flexion and adduction i.e. high chairs preferable for sitting. Avoid sitting with legs crossed. Walking poles/stick. MANAGEMENT: Physiotherapy If persistent pain despite physiotherapy refer to MSK for specialist physiotherapy assessment OSTEOARTHRITIS HIP Generally >45 years of age. INVESTIGATIONS: XRays: AP views hip If disabling symptoms, despite analgesic trial and suitable for