The hip and pelvis area of the body is very complex, with lots of joints, muscles, and soft tissues intersecting and working together to support the body. A symptom like hip pain often requires the help of a doctor to determine what’s causing the pain and how best to treat it.
Possible causes of hip pain could be osteoarthritis, bursitis, an injury to muscles, tendons, or ligaments, or other options.
Learn More: Hip Pain and Arthritis
So how does your doctor reach a diagnosis? He or she will likely rely on 3 main means of evaluation: personal history, physical exam, and imaging or lab tests.
See: Hip Osteoarthritis Diagnosis and Hip Bursitis Diagnosis
Personal history
Your doctor will ask about your family history as well as your medical history and any previous issues with hip pain or procedures. For example, a close family member with hip osteoarthritis could indicate that you have it too, since approximately 50% of risk for hip osteoarthritis is hereditary. Also, a previous hip injury can raise risk for future osteoarthritis.
Physical exam
Knowing exactly where the pain is located, what type of pain (for example, stabbing versus dull), and when it occurs can tell your doctor a lot about the likely cause. Hip bursitis often causes pain and tenderness on the very outside of the hip. Osteoarthritis pain tends to be worse after periods of inactivity, such as standing after a long time sitting or getting out of bed in the morning. Also, your doctor may palpate (touch) your hip or ask you to move in certain ways (such as standing on one leg) in order to narrow down possibilities.
Imaging and lab tests
Your doctor may be able to diagnose your hip pain without the use of imaging or lab tests, but they’re a helpful tool to reach a diagnosis if your personal history and physical exam are inconclusive.
An X-ray can reveal the condition of the bones and joints in the hip, showing a loss of joint space or the growth of bone spurs, both of which indicate osteoarthritis. However, X-rays don’t reveal details about soft tissues like tendons, muscles, or the bursa like an MRI scan can, so your doctor may order this instead of—or in addition to—an X-ray.
In addition, your doctor may want to take a sample of the fluid in the hip joint in order to conduct lab tests. This is known as joint aspiration or arthrocentesis. Not only does this allow the doctor to test the joint fluid for infections and other diagnostic clues, but it may help alleviate pain caused by swelling in the joint.
Once your doctor understands what’s causing the pain in your hip, he or she will be well equipped to offer you advice and options about the best way to treat the pain.
See: Hip Bursitis Treatment and Hip Osteoarthritis Treatment
