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Pain in the hip area can radiate to various other regions. In addition to radiating to the lower back (lumbar spine) or thighs, many of the affected patients report an additional perception of pain in the groin. Moreover, diseases of the groin region can also cause the affected patients to perceive pain in the hip.
Pain that affects the hip and the groin at the same time occurs mainly in active people and competitive athletes. Groin pain is generally one of the most common causes of training and competition failures. The so-called “inguinal hernia” plays a special role in this context.
In this disease, a hernia sac filled with intestinal sections is protruding. In most cases, the direct cause of the inguinal hernia is a weak point in the area of the abdominal wall. If the pressure inside the abdominal cavity increases (for example during pressing or sports activities), the intestine can no longer be held inside the body.
The most feared complication of the inguinal hernia is the jamming of the hernia sac in the area of the hernial orifice. Due to this condition, there is a risk that the blood vessels supplying the intestine are compressed and therefore the oxygen supply is cut off. The parts of the intestine in the hernial sac die off.
The main symptom of the inguinal hernia is a pain occurring in the groin which in many cases can radiate into the hip. A further cause for the development of hip and groin pain is muscular imbalance. Especially during sports activities, the trunk-pelvis-leg region is exposed to a high load due to swinging movements.
The muscles and ligaments of the hip region act on the groin as both static and dynamic structures. If postural deformities and/or incorrect loading occur, a dysbalance between the individual muscles occurs. As a result, the stabilizing function of the hip muscles is disturbed and stress-induced pain occurs in the hip and pelvis region.
When investigating the causes of hip pain, the patient survey is particularly important. It should show since when the complaints have been present, with which movements they are greatest and whether corresponding traumas and accidents have occurred. This is followed by a physical examination.
During this examination, the patient’s posture and gait are closely examined to see whether incorrect posture such as bow legs or knock-knees are present (indication of coxarthrosis). Both passive and active movements of the leg in the hip joint are then performed on the lying patient, paying particular attention to movements that cause the patient particularly severe pain. The physical examination is followed by the imaging diagnostics, classically first of all the conventional x-ray of the thigh of the affected side and the hip.
The images are then supplemented by a pelvic overview image. Clear fractures of the thigh or hip can be seen in this way. Also the frequently occurring arthrosis can already be seen through an X-ray of the hip.
If there are no abnormalities in the X-ray image, a CT of the hip and pelvis can be carried out in addition. In this image, even the smallest hairline cracks of the pelvis can be seen. Many pelvic ring fractures do not appear in conventional X-rays and only appear in the CT image.
In addition, a CT scan can be used to check for muscle attachments and to see corresponding hairline fractures. If a more detailed view is desired, an MRI of the pelvis should be performed. You can find more information under our topic:
- MRI of the pelvis
- MRT of the hip