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T
he majority of patients with complaints of hip pain seem to
have varying ideas on where their hip actually is. A significant
percentage of patients point to areas that are not anatomically
the hip. These areas include the lower back, the lower buttocks, the
back of the thigh, and the lower abdomen which all suggests that this
is their interpretation of the anatomical location of the hip joint.
Anatomically, the hip consists of a deep socket with a ball attached
to the proximal end of the thigh bone which articulates together. The
range of motion of the hip is usually quite extensive. For patients who
have true hip joint pain it is usually as a result of damage, irregularity
to the gliding surface of the joint or inflammatory responses to
the capsule of the joint. This is broadly defined as arthritis. The
underlying cause can be degenerative or aging arthritis, inflammatory
arthritis or post-traumatic from previous injury. Less commonly do
we see is what can be described as combined arthritic disease (CAD)
which includes both degenerative and an inflammatory component.
With pain coming from the ball and socket joint, there is usually
limitations of deep flexion at the hip, which causes difficulty with daily
living activities: car access, low seats, cleaning and toileting, dressing
of the toes, feet and ankles, the ability to put underwear on, sock
application, tying of shoelaces and difficulty with stairs.
After time, the limitation of function becomes more consistent.
Notably, the patient will develop a limp, which in medical terms can
be described as an antalgic or trendelenburg gait and a feeling (real
HIP PAIN AND REPLACEMENT
or apparent) that the limb has become
shortened on the affected side.
Investigations of patients with hip
pain involve the history and clinical
examination which point to true hip
pain. The confirmation of the pathology
that exists in the hip joint can involve
the use of radiology such as x-rays, CT
scans and MRIs and occasionally blood tests may be necessary.
The response to simple treatment can then dictate what further
responses are necessary.
Fracture & Orthopaedic Clinic has qualified specialists who can
assist in the management of your hip problem offering medical
consultation, X-rays, blood testing, MRI, gait analysis for customized
orthotics, nerve conduction testing and soft tissue ultrasound. They
accept TTARP cards and offer discounts to senior citizens.
For more information on hip and other conditions, please visit http://
by DR. DERRICK LOUSAING
B.Sc., MBBS. FRCS (ED.)
Consultant Orthopaedic Surgeon
