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 parasitic diseases (A00-B99).
- Lyme arthritis (joint inflammation caused by Lyme disease).
Mouth, esophagus (food pipe), stomach, and intestines (K00-K67; K90-K93).
- Inguinal hernia (inguinal hernia).
Musculoskeletal system and connective tissue (M00-M99)
- Atraumatic avascular femoral head necrosis (tissue destruction due to lack of blood supply to the femoral head; in this case, neither due to accident nor vascular) – caused by ischemic undersupply (reduced blood supply) of the hip joint due to, for example, smoking, high alcohol consumption, obesity, side effects of chemotherapy and glucocorticoids; symptomatology: similar to coxarthrosis (hip osteoarthritis), but much faster progression.
- Ligament degeneration
- Bursitis trochanterica – bursitis in the area of the hip.
- Bursitis pectinea – bursitis in the area of the pectineus muscle.
- Coxarthrosis (osteoarthritis of the hip joint) – the most common cause of coxalgia! Favoring factors are: Malpositions (hip dysplasia, femoral neck), inflammatory or traumatic previous damage, permanent incorrect loading (knock knees or bow legs), overloading of the hip joints (overweight, leg length difference) and metabolic diseases; Symptomatology: start-up pain.
- Coxa saltans (snapping hip).
- Coxa saltans interna: painful jumping and rubbing of the iliopsoas tendon esp. during extension movements (stretching movements) of the hip from the flexion position/bending position (> 90°); symptomatology: anterior hip/groin pain (hip/groin pain), which is intensified by active extension from maximum flexion.
- Coxa saltans externa: lateral jumping of the tractus iliotibialis or the tendon plates of the gluteus maximus (large gluteal muscle) or tensor fasciae latae inserting into it over the greater trochanter (transition area between the femoral body (corpus femoris) and the neck of the femur (collum femoris)); often bilateral (on both sides); incidence (frequency of new cases): 5-10%.
- Coxitis (hip joint inflammation), unspecified; native hip joint infection or periprosthetic infection (PPI; see “Operations” below); risk factors: Obesity, diabetes mellitus, malignancies (cancers), rheumatoid arthritis, revision arthroplasty, and immunosuppression (suppression of the immune system); symptomatology: Local signs of inflammation (swelling, redness or hyperthermia) (can occur at any age; but preferably in infants or young children < 4 years)Most common differential diagnoses in infants and children (2 to 10 years) with coxitis are coxitis fugax and idiopathic necrosis of the femoral head (Perthes disease).
- Coxitis fugax (hip flare) – non-infectious inflammation of the hip joint with spontaneous healing; for diagnosis: X-ray: structural disturbance of the femoral head; sonography: effusion; inflammatory parameters (eg, CRP): negative (one of the most common reasons for emergency medical consultation)The disease is self-limiting; mean duration of symptoms about 5 days, in protracted course, this can be up to 14 days.
- Epiphysiolysis capitis femoris (ECF, epiphyseal loosening) – due to loosening in the epiphyseal gap, there is a slippage of the growth plate of the femoral head; occurrence between the 9th year of life and the completion of growth; affected are mainly boys in puberty (about > 9. Lebensjahr); ratio of boys to girls is about 3: 1; incidence (frequency of new cases) of 10.8 diseases per 100,000 population, thus the most common hip disease in adolescents; usually the children are overweight; patients typically complain of groin, knee and hip complaintsNote: pain in the knee, never forget the hip!
- Femoroacetabular impingement (FAI); motion-dependent tightness between the femoral head and acetabulum (hip impingement); usually affects young, athletic men; however, may become symptomatic only at an advanced age; symptoms: shooting groin pain, symptoms of entrapment during deep hip flexion with inward rotation of the leg; pain during long periods of sitting
- Fibromyalgia (fibromyalgia syndrome) – syndrome that can lead to chronic pain (at least 3 months) in several regions of the body.
- Gluteal tendon syndrome – caused by tears near the attachment at the junction of the gluteus medius to the gluteus minimus in femoral neck fractures.
- Greater-trochanteric-pain syndrome (GTPS) – magnetic resonance imaging (MRI) and sonography show here tendon and bursal changes in the trochanteric area; Symptomatology: lateral hip pain with painful pressure point over the greater trochanter in the area of the attachment of the gluteus medius, possibly also somewhat cranial; Incidence (frequency of new cases): 10-20% of the adult population.
- Hip dysplasia – congenital (congenital) or acquired deficient ossification of the hip joint with inferior roofing of the femoral head; affected are mostly younger patients; symptomatology: stabbing groin pain, possibly also lateral hip or buttock pain.
- Hip joint dislocation (hip dislocation) – in this case, the femoral head is displaced from the acetabulum.
- Femoral head necrosis – death of the femoral head due to reduced blood flow.
- Risk group: including patients with HIV.
- Sacroiliac joint blockage – painful blockage of the intestinal / sacral joint.
- Sacroiliac joint syndrome (disease of the sacroiliac joint) – symptomatology: seizure-like shooting low back and buttock pain, after trunk rotation / bending.
- Insertion tendinopathy (due to irritation at the junction between tendons and bones, i.e. pain conditions arising in the area of insertion) due to muscle overuse.
- Juvenile idiopathic rheumatoid coxitis – chronic inflammatory disease of the joints (arthritis) of the rheumatic form in childhood (juvenile) of unknown cause (idiopathic)Note: Here, a joint puncture should always be done if an infectious cause of the joint effusion appears possible
- Lyme arthritis (joint inflammation due to Lyme disease).
- Bekhterev’s disease (ankylosing spondylitis) – chronic inflammatory rheumatic disease that leads to pain and stiffness of the spine and sacroiliac joint.
- Perthes disease – aseptic bone necrosis (necrosis (tissue death) of bones occurring in the absence of infection (“aseptic”) due to an insufficient supply of blood (ischemia)) of the caput femoris (femoral head; femoral head), which occurs in childhood; the causative factor is a circulatory disorder of unclear genesis; clinical picture: Physical examination shows a painfully limited ability to rotate internally (internal rotation: when a direction of rotation points inward when viewed from the front) of the hip, reduced abduction (moving a part of the body away from the body axis) in hip extension and a right-sided positive Drehmann sign (is present when 90 ° flexion in the hip joint is possible only with abduction and external rotation of the leg).
- Muscle strain (distension)
- Osteomalacia (softening of the bones)
- Osteoporosis
- Polymyalgia rheumatica
- Piriformis syndrome – nerve compression syndrome: compression of the ischiadic nerve (sciatic nerve) as it passes through the infrapiriform foramen between the pelvic bone and the piriformis muscle; symptomatology: ischiadic complaints with radiation from gluteal (“pertaining to the buttocks”) or sometimes lumbar (“pertaining to the lumbar region”) along the supply area of the nerve. Ischiadicus; amplification of the complaints when sitting and stretch stress of the nerve.
- Psoas pain – pain in the area of the iliopsoas muscle; muscle needed for flexion and external rotation of the leg.
- Rheumatic diseases, unspecified
Neoplasms – tumor diseases (C00-D48)
- Bone tumors (esp. in children).
- Metastases (daughter tumors), unspecified neoplasms (bronchial, breast, kidney, prostate and thyroid carcinomas and multiple myeloma).
- Neoplasms, unspecified (both benign and malignant).
Psyche – nervous system (F00-F99; G00-G99).
- Meralgia paraesthetica (synonym: Bernhardt-Roth syndrome) – nerve pain due to compression of the lateral cutaneus femoris nerve under the inguinal ligament.
- Spastic cerebral palsy – permanent neurological disorders that occur as a result of cerebral damage in early stages of development; in this case: statistical muscular imbalances leading to hip lateralization (“shifting to one side”) and consequent hip dislocation (children)
- Spinal stenosis (narrowing of the spinal canal).
Symptoms and abnormal clinical and laboratory findings not elsewhere classified (R00-R99).
- Groin pain (LS), idiopathic Note: Groin pain occurs predominantly in sports with many rapid lateral movements and changes in direction, as well as “stop-and-go” movements. Per Doha consensus, the following terminology and definition of groin pain in athletes was made:
- Entities of groin pain (LS): adductor-associated LS, iliopsoas-associated LS, inguinal LS, and pubis-associated LS,
- Hip-associated groin pain.
- Other causes of groin pain in athletes
Genitourinary system (kidneys, urinary tract – reproductive organs) (N00-N99).
- Onward pain from urinary tract infections.
Injuries, poisonings, and other consequences of external causes (S00-T98)
- Fracture (bone fracture)
- Proximal femur fracture – fracture of the femur located on the half of the bone facing the center of the body.
- Fracture of the femoral head
- Femoral neck fracture
- Pertrochanteric femur fracture – femur fracture that pulls through the rolling mound.
- Subtrochanteric femoral fracture – femoral fracture that passes under the rolling mound.
- Femoral shaft fracture
- Acetabular fracture (fracture of the acetabulum)
- Injuries of the hip, unspecified
Operations
- Condition after total hip arthroplasty (TEP; artificial joint replacement) of the hip joint; symptomatology: lateral hip or buttock pain wg.
- Gluteal insufficiency due tosurgery- and access-related muscle damage.
- Psoas impingement resulting in chronic irritation of the tendon of the iliopsoas muscle
- Periprosthetic infection (PPI).
