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Hip joint pain referral patterns: a descriptive study

PainSci » bibliography » Lesher et al 2008

Two articles on PainSci cite Lesher 2008: 1. The Complete Guide to IT Band Syndrome2. IT Band Pain is Knee Pain, Not Hip Pain

PainSci notes on Lesher 2008:

Conventional wisdom says hip joint pain usually refers to the groin and thigh, and both of these are common (each seen in about half of patients)… but investigating this phenomenon Lesher et al. found that buttock pain is even more common at 70%, and even lower leg pain is also surprisingly common at 20%.

Foot? 6%! Imagine that one. “Doctor, my foot hurts.” “Hmm, could be hip trouble…”

Knee? 2%?

So there is real potential to mistake hip arthritis for other issues, especially sciatica and greater trochanteric pain syndrome.

Location Percentage of Patients
Buttock 71
Thigh: 57
 Anterior 27
 Lateral 27
 Posterior 24
 Medial 16
Groin 55
Leg 16
 Lateral 8
 Posterior 8
 Anterior 4
 Medial 2
Foot 6
Knee 2

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

OBJECTIVE: To determine hip joint pain referral patterns.

DESIGN: Retrospective analysis. Setting. Multicenter. Patients. Fifty-one consecutive patients meeting clinical criteria of a symptomatic hip joint. Interventions. Fluoroscopically guided intra-articular hip joint injection. Outcome Measures. Anatomic pain map before hip injection and visual analog scale both before and after hip injection.

RESULTS: The hip joint was shown to cause pain in traditionally accepted referral areas to the groin and thigh in 55% and 57% of patients, respectfully. However, pain referral was also seen in the buttock and lower extremity distal to the knee in 71% and 22%, respectively. Foot and knee pain were seen in only 6% and 2% of patients, respectively, while lower lumbar spine referral did not occur. Fourteen pain referral patterns were observed.

CONCLUSIONS: Buttock pain is the most common pain referral area from a symptomatic hip joint. Traditionally accepted groin and thigh referral areas were less common. Hip joint pain can occasionally refer distally to the foot. Lower lumbar spine referral did not occur.

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