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Anatomy of Hip

Hip pain is not always just felt directly over the hip. Instead, you may feel it in the middle of your thigh or in your groin. Similarly, pain you feel in the hip may actually reflect a problem in your back, rather than your hip itself. It is extremely important for a professional to make an accurate diagnosis of the cause of your symptoms so that appropriate treatment can be directed at the underlying problem.

Anatomy of the Hip

Hip Joint AnatomyThe hip joint is a ball and socket joint. The femoral head (ball) sits in the acetabulum (socket). Underneath the femoral head lies the femoral neck. Two prominences in the upper part of the femur, the greater trochanter and the lesser trochanter, allow the attachment of muscles onto the bone. The joint surfaces are covered by several millimetres of articular cartilage, which can be seen as a gap between the bones on a hip x-ray.

The hip joint is enveloped by thick ligaments binding the femur and acetabulum together. At the front the ligaments extend down on the line between the greater and lesser trochanter (intertrochanteric line) and at the back of the hip the ligaments insert much higher up on to the femoral neck.

The hip socket is deepened by a thick rim of fibrocartilage that runs around the lip of the acetabulum. This lip is called the acetabular labrum (shown in blue on the image below) and can be a source of pain in patients with a labral tear. The head of the femur is connected to the acetabulum by an internal ligament (ligamentum teres) which is probably more important as a blood supply to the femoral head during growth.

Symptoms of Hip Injury

Depending on the condition that’s causing your hip pain, you might feel the discomfort in your:

  • thigh
  • inside of the hip joint
  • groin
  • outside of the hip joint
  • buttocks

Sometimes pain from other areas of the body, such as the back or groin (from a hernia), can radiate to the hip.

The location and severity of hip pain may vary, depending on the cause of the problem. Signs and symptoms that sometimes accompany hip pain include:

  • Swelling and stiffness
  • Redness and warmth to the touch
  • Weakness or instability
  • Popping or crunching noises
  • Inability to fully move the ankle
  • Inability to weight bear on the ankle

For patients suffering from hip pain, the first step to recovery is to receive a proper diagnosis so the cause of the symptoms can be determined.

Some hip pain symptoms are considered to be more serious and may point to serious medical conditions. If any of the following symptoms associated with hip pain is felt, consult a professional immediately:

  • Weight Loss
  • Night Pain
  • Trauma
  • Feeling unwell
  • Fever and night sweats
  • Inability to weight bear
  • Deformity
Causes of Hip Pain

The hip joint is designed to withstand repeated motion and a fair amount of wear and tear. Whenever you use the hip (for example, by going for a run), a cushion of cartilage helps prevent friction as the hip bone moves in its socket. Despite its durability the hip joint can be injured directly or by a disease process. With age and use, the cartilage can wear down or become damaged. Muscles and tendons in the hip can get overused. The hip bone itself can be fractured during a fall or other injury. Any of these conditions can lead to hip pain. Here is a general list of causes of hip pain:

Arthritis
Juvenile rheumatoid arthritis
Osteoarthritis
Psoriatic arthritis
Rheumatoid arthritis
Septic arthritis

Injuries
Bursitis
Dislocation
Hip fracture
Hip labral tear
Inguinal hernia
Sprains and strains
Pelvis fracture
Tendinitis
Pinched nerves
Herniated disc
Meralgia paresthetica
Sacroiliitis
Sciatica
Spinal stenosis
Cancer
Advanced (metastatic) cancer that has spread to the bones
Bone cancer
Leukaemia

Other Problems
Avascular necrosis
Legg-Calve-Perthes disease
Osteomalacia
Osteomyelitis
Osteoporosis
Paget’s disease of bone
Rickets
Synovitis

Investigations for Hip Pain and Injury

Like every joint evaluation, the start to a diagnosis is a consultation followed by a physical examination. Your specialist will inspect your hip for swelling, pain, tenderness, warmth and visible bruising. A visual assessment is followed by evaluation of the movement and specific orthopaedic tests to determine integrity.

After a provisional diagnosis is made by your specialist, it may be suggested you have the joint imaged by:

  • X-ray
  • MRI Scan
  • CT Scan
  • Ultrasound

If your specialist suspects an infection or arthritis you may be recommended a series of have blood tests .

On rare occasions your specialist may request a nerve conduction study to look for nerve injury and compression.

Treatments for Hip Pain

Throughout your diagnosis, treatment, and rehabilitation, dedicated team members will continue to work hard to ensure you can get back to enjoying life with the most comfort, mobility, and functionality possible.

Healthplus Clinics has assembled a group of Hip Pain Specialists to provide complete surgical and non-surgical treatments. Our team of Hip Specialists includes: Hip Surgeons, Pain Specialists, Podiatrists, and specially trained Hip Physiotherapists.

Non-Surgical Hip Treatments and Procedures

  • Specialist Hip Physiotherapy
  • Gait Analysis and Biomechanical Examination
  • Orthotics Prescription
  • Shockwave Therapy
  • Hip Acupuncture
  • Electrotherapy

Hip Pain Management Procedures

  • Hip joint injection
  • Trochanteric bursa injection

Surgical Hip Treatments and Procedures

  • Arthroscopic Treatment of Femoro-acetabular impingement
  • Girdlestone Operation
  • Hip Arthroplasty
  • Hip Arthroscopy
  • Hip resurfacing
  • Minimally Invasive Total Hip Replacement
  • Short stem prosthesis hip
  • Total Hip replacement
  • Trochanteric bursitis removal
Complications of Hip Pain and Injury

Chronic pain

Once your ligaments are stretched or torn, they need considerable time to be fully healed and are pain free. But other problems might go undiagnosed, like a bone fracture, tear in the cartilage, nerve damage or a torn tendon. Delaying treatment of these other conditions leads to continued pain, weakness, giving way and disruption of your normal daily activities.

Instability of the Hip Joint

If this happens, you will are likely to recurrently injure the hip joint causing swelling and pain.

Stiffness

Stiffness usually happens because of severe inflammation swelling at the site of the injury and scar tissue. Stiffness most often results in pain and even osteoarthritis.

Swelling

When the hip does not heal properly, localized swelling occurs causing a limited range of motion and an inability to participate in your usual routine.

Early onset arthritis in the Hip Joint

When a joint functions incorrectly following injury there is a possibility that over a period of time premature arthritis can occur.

Most patients will not encounter problems after orthopaedic surgery. As with any surgery, however, there are potential risks, including: reaction to anesthesia, bleeding, infection, blood clots, nerve damage, lack of full range of motion, development of arthritis, scar formation, or re-injury of the joint or soft tissue.

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