Anterior Hip Pain
American Family Physician, Oct 15, 1999 by John W. O'Kane
Anterior hip pain is a common complaint with many possible causes. Apophyseal avulsion and slipped capital femoral epiphysis should not be overlooked in adolescents. Muscle and tendon strains are common in adults. Subsequent to accurate diagnosis, strains should improve with rest and directed conservative treatment.
Osteoarthritis, which is diagnosed radiographically, generally occurs in middle-aged and older adults. Arthritis in younger adults should prompt consideration of an inflammatory cause. A possible femoral neck stress fracture should be evaluated urgently to prevent the potentially significant complications associated with displacement.
Patients with osteitis pubis should be educated about the natural history of the condition and should undergo physical therapy to correct abnormal pelvic mechanics. "Sports hernias," nerve entrapments and labral pathologic conditions should be considered in athletic adults with characteristic presentations and chronic symptoms.
Surgical intervention may allow resumption of pain-free athletic activity. (Am Fam Physician 1999;60: 1687-96.)Anterior hip pain is a common problem that is frequently difficult to diagnose and treat.1 Determining the exact cause of hip pain can be difficult for several reasons.
The multiple structures in the hip have the potential to produce similar pain syndromes; in addition, pain in the hip region may come from deep structures that are not palpable. Pathologic conditions ranging from a benign muscle or tendon strain to a potentially catastrophic femoral neck stress fracture can have similar clinical presentations.
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