Hip Pain in Adolescence and Adulthood

My Approach

Hip pain in adolescents and adults is quite common.  There are many causes and the most important factor is determining the reason and cause of the pain. Pain in the hip can be as a trauma as simple as a muscle strain or sprain, to an over use injury such as a stress fracture, to loss of blood supply called avascular necrosis,  to a hip that developed too shallow (hip dysplasia) to a hip that may be mal-oriented or too deep and causing hip impingement.

Therefore, hip pain cannot be lumped into one and each condition has its own unique management features. For instance, a hip sprain many need exercises and physical therapy while hip dysplasia requires surgical reconstruction of the hip.

More Information on Hip Pain in Adolescence and Adulthood

Hip Dysplasia:

Often not diagnosed until teenage years to adulthood, hip dysplasia is often a shallow socket (acetabulum) and/or a rotated femur (excessive anteversion or retroversion).  Hip dysplasia often will put pressure on the side of the acetabulum (cup of the hip) causing a labral tear (the shock absorber of the hip).  Patients often complain of with increasing activity such as hiking.  Once the labrum tear then pain occurs even with sitting.



Cause

There are many causes of hip pain in adulthood.  Some are inborn, such as a shallow hip and hop impingement, while others may be related to trauma or over-use.  Some causes of hip pain are unique such as Avascular Necrosis and Slipped Capital Femoral Epiphysis.  These will be discussed separately.



Diagnosis Methods

Physical examination will often reveal the diagnosis. Along with x-rays, CT Scan and MRI when needed, a definitive diagnosis for the hip pain should be made.



Treatments

Given that the condition is relatively rare, few surgeons and therapists are experienced enough to treat this disease effectively. Arthrogryposis requires very complex treatment and should only be undertaken by physicians, surgeons, and allied health professionals who are not only familiar with the disease but also have a high level of expertise in treating arthrogrypotic patients.

I believe that if a child is to have surgery, there must be an expected outcome that can change the child’s life. To achieve the best functional outcomes, I take into account the underlying muscle strength of the patient, outline realistic goals, assess the potential benefits of treatment, and partner with an exceptional team of experienced medical professionals to provide treatment. This ensures that children do not undergo multiple painful surgeries that make very little change in their condition.

Non-Surgical Treatments
  • Occupational/Physical Therapy
  • Casting / Splinting
  • Psychosocial and Emotional Therapy
Surgical Treatments
  • Soft Tissue Release
  • Tendon Transfer
  • Osteotomy
  • Frames & Devices (Fixators)
  • Growth Modulation

 



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