December 2012 · Vol. 61, No. 12: 736-744Hip pain in active patients: What you may be missing
When a patient who’s physically active complains of hip pain, don’t be too quick to label it a “hip pointer” that requires time and rest to heal. Consider this more nuanced—and effective—approach.
Rachel
M.
Frank,
MDDivision of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Ill
mfrank3@gmail.com Mark
A.
Slabaugh,
MDDivision of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Ill Robert
C.
Grumet,
MDDivision of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Ill Charles
A.
Bush-Joseph,
MDDivision of Sports Medicine, Hip Preservation Center, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Ill Walter
W.
Virkus,
MDDivision of Sports Medicine, Hip Preservation Center, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Ill Shane
J.
Nho,
MD, MSDivision of Sports Medicine, Hip Preservation Center, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Ill The authors reported no potential conflict of interest relevant to this article.
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PRACTICE RECOMMENDATIONS
• Consider both musculoskeletal and nonmusculoskeletal causes in patients with vague complaints of hip and groin pain. B
• Use imaging studies to confirm a hip pain diagnosis. B
• Refer patients who fail to respond to nonsurgical treatment to a sports medicine specialist or an orthopedic surgeon. B
Strength of recommendation (SOR)
A Good-quality patient-oriented evidence
B Inconsistent or limited-quality patient-oriented evidence
C Consensus, usual practice, opinion, disease-oriented evidence, case series
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Hip pain is a common complaint, and commonly misunderstood. Although the pain can be associated with a broad spectrum of conditions, the presentation is often vague and nonspecific.Thus, hip pain and injury are frequently attributed, often incorrectly, to a “hip pointer”—a contusion of soft tissues against the iliac crest. It’s not unusual for patients who receive this diagnosis to be treated conservatively for prolonged periods, leading some previously active individuals to abandon their favorite sport or self-impose limits on the activities they engage in.1
But it doesn’t have to be this way.
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