Diagnosing hip pain - Dr. Michael Lehmann

Diagnosing hip pain

The physical - or clinical - examination follows a detailed history-taking. This generally involves looking at the patient in various positions (inspection), feeling the joints concerned (palpation), various functional tests and an assessment of how far the patient is able to walk (without pain). With hip problems, especially, a precise examination of the standing patient can often be very informative on its own. Differences in leg length or muscle strength are immediately apparent to an expert eye. By using palpation and specialist instruments, it is possible to determine whether there is any problem with the blood flow or nerve conduction.

Range of movement of the hip

It is also important to observe how the patient moves and most importantly how he walks. This observation looks, for example, at how great the possible range of movement of the hip is, and how wide the legs can be spread before the hip pain starts.

Imaging methods such as X-rays, ultrasound and MRI are essential for initiated targeted treatment.

Blood tests may also need to be sent to the laboratory to determine the level of inflammation involved.

Treatment by specialists

The physical examination findings and imaging shed light on the cause of the problem. In relation to the imaging method especially, correct interpretation of the findings is crucial.

You should therefore consult an experienced hip specialist who has adequate expertise in the manual investigation of the hip.

What imaging methods are helpful for diagnosing hip pain?

Accurately-performed X-rays, for example, are important, in which specialist projection methods are used depending on the information required.

Computed tomography (CT) is also valuable for diagnosing hip pain, as it allows bony joint changes in particular to be assessed very accurately and the diseased structures can be visualised in three dimensions.

The option of magnetic resonance imaging (MRI) should also be available, which - unlike X-rays and CT scans - allows soft tissue damage to be clearly detected, such as tears in the joint cartilage or labral defects. Ultrasound examinations can also yield valuable additional information. These can be carried out easily with the appropriate expertise and do not expose the patient to X-ray radiation.