In my busy orthopedic practice, many patients present with a chief complaint of “hip pain.” Muscles and tendons around the hip are easily “stretched, pulled, irritated, or just plain sore.” However, there are multiple hip problems that occur in patients of all ages. These can start with the smallest babies. Despite increasing awareness of hip dysplasia, some children go undiagnosed with this hip deformity that can eventually lead to early arthritis. I rarely go a month without seeing an adult patient with hip pain now requiring a hip replacement, whose dysplasia was not identified as a baby. Providers must be vigilant in checking every child’s hips at every examination from newborn to age one. Testing a baby for a “hip click” is so easy to do. Any question of a positive test requires further evaluation including an ultrasound to confirm the diagnosis. Dysplasia is easily treated in the first year of life with a brace.
Hip impingement, now termed “Femeroacetabular Impingement Syndrome,” is another diagnosis that has always been around. With the dramatic improvements in hip arthroscopy over the past ten years, effective treatment of this problem is now much more readily available. Hip impingement occurs when a bump (called a CAM lesion) on the femoral head rubs on the labrum and bone of the hip socket (the acetabulum). Over time this causes “a pinching pain” in the groin and eventual painful clicking, popping, or catching with hip rotation. Plain radiographs show the bony abnormality. An MRI arthrogram confirms a torn labrum. Conservative treatment such as physical therapy, anti-inflammatory medications or cortisone injections can help with early symptoms. However, hip arthroscopy is now very successful in eliminating the bone impingement and even repairing a torn labrum.
See Scott Frischknecht, PA-C, DFAAPA speak at our San Antonio and Las Vegas events in 2016.