Medical history (history of the patient) is an important component in the diagnosis of coxalgia (hip pain). Family history Are there any bone/joint conditions in your family that are common? Social history What is your profession? Do you work physically hard in your profession? Current medical history/systemic history (somatic and psychological complaints). Where is the … Hip Pain (Coxalgia): Medical History
Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99). Hip dysplasia – congenital malformation of acetabulum leading to congenital hip dislocation (hip joint dislocation). Cardiovascular system (I00-I99) Peripheral arterial occlusive disease (pAVD) – progressive narrowing or occlusion of the arteries supplying the arms/ (more commonly) legs, usually due to atherosclerosis (arteriosclerosis, hardening of the arteries). Infectious and … Hip Pain (Coxalgia): Or something else? Differential Diagnosis
The following are the most important diseases or complications that can be caused by coxalgia (hip pain): Musculoskeletal system and connective tissue (M00-M99). Movement restriction/restraint
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing) of the lumbar-pelvic-hip region in its entirety while standing, supine, lateral and prone. Skin (normal: intact; (abrasions/wounds, redness, hematomas (bruises), scars) and mucous membranes. Gait (fluid, limping). Body or … Hip Pain (Coxalgia): Examination
2nd order laboratory parameters – depending on the results of the history, physical examination and obligatory laboratory parameters – for differential diagnostic clarification. Small blood count [septic arthritis (inflammatory joint disease)/osteomyelitis (bone marrow inflammation): leukocytes ↑] Inflammatory parameters – CRP (C-reactive protein) [septic arthritides/osteomyelitis: CRP ↑]Note: Inflammatory parameters may not be elevated or only slightly … Hip Pain (Coxalgia): Test and Diagnosis
Therapy goals Reduction of pain and thus increase of mobility. Diagnosis finding Therapy recommendations Analgesia (pain relief) during diagnosis until definitive therapy according to WHO staging scheme: Non-opioid analgesic (paracetamol, first-line agent) – see also “Further notes”. Low-potency opioid analgesic (e.g., tramadol) + non-opioid analgesic. High-potency opioid analgesic (eg, morphine) + non-opioid analgesic. If necessary, … Hip Pain (Coxalgia): Drug Therapy
Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics, and obligatory medical device diagnostics – for differential diagnostic clarification. Radiographs of the hip joint and lumbar spine (LS) (in 2 planes) – to exclude or detect: Positional abnormalities, dysplasias, inflammatory, degenerative, tumorous and traumatic processes in the lumbar … Hip Pain (Coxalgia): Diagnostic Tests
The following symptoms and complaints may indicate coxalgia (hip pain): Main symptoms Groin pain/groin pain (common). Lateral hip pain (common) Lateral buttock pain (common) Gonalgia (knee pain; less common). Deep-seated low back pain (less common) Lower abdominal pain (less common) Secondary symptoms Limping Radiating pain to upper/lower thigh, pelvis. Movement restriction (or load refusal). Gentle … Hip Pain (Coxalgia): Symptoms, Complaints, Signs
General measures Nicotine restriction (refraining from tobacco use). Avoidance of: Overloading of the joints, for example, by competitive and high-performance sports or long-lasting heavy physical loads, for example, in the profession (construction workers, especially floor layers). Operative therapy In cases of pronounced coxarthrosis (osteoarthritis of the hip joint), total hip arthroplasty (hip joint prosthesis) is … Hip Pain (Coxalgia): Therapy
