What are the causes of pain at the front of the hip?
Pain at the front of the hip can be due to a variety of causes, these include:
Hip joint osteoarthritis
Hip osteoarthritis is a common cause of hip and groin pain, mainly affecting people over 50. It is usually a progressive condition due to wear and tear changes to the hip joint articular cartilage. This results in the loss of the protective, shock-absorbing function of the cartilage. If this progresses, there might be a complete loss of the articular cartilage, and the unprotected joint surfaces come into contact. This is called “bone on bone” and indicates severe osteoarthritis. Please read our article to find out more about the stages of hip arthritis. The diagnosis can be confirmed by imaging, starting with a hip x-ray. Ultrasound-guided hip joint steroid injections can be very useful in confirming the cause of symptoms and providing effective pain relief and anti-inflammatory effects. Please see our article to find out more about steroid injections around the hip. Hyaluronic acid injections are an alternative therapy for hip osteoarthritis with very good results, particularly in the mild and moderate forms of the disease. To find out more, please see our article about Hip joint osteoarthritis.
Femoroacetabular impingement
Femoroacetabular hip impingement (FAI) usually refers to a bony impingement that can happen at the front and outer aspect of the hip joint. FAI usually results from altered bony anatomy (namely a pincer or cam-type bony morphology). These can predispose to injury of an important cartilaginous structure within the hip joint “called the labrum”. To find out more, please see our article about femoroacetabular impingement.
Iliopsoas bursitis/tendinosis
The iliopsoas tendon runs in front of your hip joint, and the iliopsoas is the main muscle responsible for hip flexion (lifting up your hip and knee, like the movement you do to get out of the car). Iliopsoas tendonitis/tendinopathy refers to inflammation and irritation of the tendon. This tends to be an overuse injury when there is repetitive hip flexion (for example, in running and cycling). It can also be seen in patients with a hip replacement, as this can cause iliopsoas tendon irritation. This condition can be associated with fluid accumulation between the tendon and the hip bone within a small sac "called the psoas bursa". The condition is referred to as “iliopsoas bursitis”. The main symptom of psoas bursitis/tendonitis is pain at the front of the hip joint or groin. The pain usually worsens when performing activities that involve hip flexion, like getting out of the car, going upstairs and running. The condition can be associated with snapping; ultrasound assessment is very useful here. One treatment option is managing the underlying condition with an ultrasound-guided steroid injection. To learn more, please see our article about Iliopsoas bursitis/tendinosis.
Adductor tendinosis/tear
Osteitis pubis is an umbrella term that describes a few conditions, all causing pain around the pubic symphysis. The pubic symphysis is a small joint at the front of the pelvis in the body's midline, immediately above the genitals. The two bones on each side of the joint (called the pubic bones) provide attachments to the muscles of the inner thigh and the abdomen and, therefore, can undergo stress due to sports or repeated activities. Osteitis pubis is more common in men, particularly if doing sports and in pregnant ladies.
Please see our article about Adductor tendinosis/tear to find out more.
abdominal hernia
Ultrasound is an excellent modality to assess suspected groin hernias and other lumps within the groin and the abdomen. It can accurately perform a dynamic assessment of the hernia to see the movement of the hernia content. To find out more, please see our article about abdominal hernias.
Sciatica
A pinched nerve in the back is a common condition in our practice. It usually results from disc herniation, causing pressure on the lower spine's nerves. The patient usually presents with pain, numbness and possibly weakness in the leg. The condition is also called “sciatica” and "radiculopathy". MRI is very useful for the assessment here. To find out more, please see our article about Sciatica.
Hip conditions and treatments
