Video presented by Ana Bracilovic, MD
This video accompanies the article: What Is Hip Osteoarthritis?
In addition to the bones, muscles, tendons, and ligaments, the cartilage is what lines the joints. Basically, it is what gives us good shock absorption. Within the hip joint, the cartilage lines the ball of the ball-and-socket joint, and provides a padded cushion for absorption. In osteoarthritis, this cushion starts to break down, and that’s when this degenerative process begins and we begin to lose cartilage.
What are the Symptoms of Hip Pain from Arthritis?
Symptoms of hip pain that are coming from arthritis can be intermittently dull and intermittently sharp. Patients will typically describe pain that is worse in the morning and lasts for less than 30 minutes. Typically they will feel some anterior pain in the groin and some anterior thigh pain. It can be worse with going up and down stairs, it can be worse with bending over, it can be worse with sitting for prolonged periods.
That varies more specifically with each of the patients’ symptoms. Occasionally, the patient can also feel some buttock pain. It can be throbbing or sore in nature; there may or not be associated lower back pain. Typically, pain from the hip does not radiate beyond the knee.
How do Doctors Diagnose Hip Osteoarthritis?
In diagnosing hip pain from arthritis, typically when the patient comes in, they will tell us what their symptoms are. It’s important to assess how long the symptoms have been going on for, when did they begin, their intensity, how bad does the pain get, what is it currently, and how bad does it get at worst, how long has it lasted, are there any movements that the pain better or worse, does the patient describe the pain as dull and aching or sharp or stabbing, is there any radiation of the pain, or is it more localized?
After the interview and history, we do a good physical exam. That physical exam involves testing the strength of the muscles, including the back, legs, and feet, testing the patient’s sensation, testing the reflexes, and doing a few provocative maneuvers that are good at ruling out whether the pain is coming intrinsically from the hip joint versus pain that’s coming from ligaments, tendons, muscles, or something that’s not arthritic.
Following the physical examination for arthritis, a radiograph is usually the first test we would order. The actual diagnosis of osteoarthritis is usually done by radiograph. From the radiograph (which is an X-Ray), you can tell the condition of the bones and health of the bones as well as the degree of the arthritis. If there is any question of any other additional soft tissue involvement, whether we’re looking at the actual capsule of the joint, or any of the surrounding muscles, tendons, or ligaments, then we can do an MRI. But typically, the radiograph is sufficient to diagnose hip arthritis.
There are no actual lab tests that can diagnose hip osteoarthritis. Unless we are suspecting something that is more systemic such as rheumatoid arthritis, or other systemic diseases such as lupus or ankylosing spondylitis (which may present in a similar fashion), normally we don’t by default order lab work.