Hip Osteoarthritis

Hip osteoarthritis can manifest as pain in the hip/groin (aggravated with activity, alleviated by rest), most commonly in adults over 40 years of age. Pain is normally reproducible with movement, particularly near terminal range of motion. Over time, pain worsens and range further restricts. A more sudden painful onset is concerning for fracture, osteonecrosis, synovitis, or septic arthritis. Plain weight-bearing AP pelvic radiographs provide adequate evidence (joint space narrowing, subchondral sclerosis, and osteophytes) of osteoarthritis. Reserve more involved imaging for patients with history, physical exam, and radiographic findings that are inconclusive. Conservative management includes activity/lifestyle modifications, exercise and physical therapy, pharmacologic symptomatic management (acetaminophen, NSAIDs), intra-articular glucocorticoid injections, and surgery if refractory.