| Assessment of the Hip Joint |
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Problems inside the joint usually create symptoms in front of the hip in the groin region, sometimes radiating down the inside of the thigh even as far as the knee. Pain in the back of the hip is more commonly associated with problems of the lumbar spine or sacroiliac joint. Tenderness along the outside of the hip is often seen with bursitis or tendonitis and is easily elicited by producing pain when pushing over these areas. In contrast, hip joint symptoms are deep seated, and it is hard to push on a spot that creates the type of symptoms that occur with activities. Pain associated with problems inside the joint that are potentially amenable to arthroscopy tend to have a “mechanical” character; they are somewhat intermittent and can be described as sharp, stabbing, or catching in nature. Simply aching, or aching that is independent of activity is sometimes associated with more of an arthritic process or condition that may be less correctable. Hip joint problems tend to be aggravated by torsional maneuvers more than straight plane activities. For example, turning, twisting, changing direction may be more troublesome than walking or even jogging straight ahead. Level surfaces are better tolerated than stairs or inclines, which typically cause more difficulty. Activities such as entering and exiting an automobile may exacerbate symptoms and be particularly noticeable. Even just, rising from a seated position will sometimes result in a painful catching type sensation. Dyspareunia because of hip pain is not uncommon. With more advanced problems and loss of rotational motion in the hip, people start to have difficulty getting shoes and socks on and off. These are just a few of the characteristic symptoms that might indicate a problem emanating from inside the joint. Also, with long-standing joint trouble, secondary problems start to develop as the body compensates for the hip. These may include muscle soreness, bursitis, tendinitis, or even back symptoms. These may obscure the hip as the principal underlying problem. An experienced examiner can usually tell whether the hip is involved, but determining the exact nature of the underlying disorder can then become more of a challenge. |
