Condition	History	Signs	Tests	Management
Avascular necrosis of the femoral head	Pain with insidious onset that is worse with weight bearing; recent trauma or corticosteroid use	Pain with all hip motions, antalgic gait	Radiography, MRI	Surgery or close observation by an orthopedic surgeon
Bursitis	Hip pain with exercise or direct pressure	Tender bursa over greater trochanter or iliopsoas tendon; may accompany intra-articular hip pathology	Usually none; MRI or ultrasonography can confirm	Physical therapy, corticosteroid injection; arthroscopic debridement if refractory
Cancer	Fever, night sweats, night pain, weight loss, history of cancer	Soft tissue mass near hip (e.g., sarcoma), pelvic mass, lumbar radiculopathy (if lumbar tumor)	Radiography, CT (hip, pelvis, or lumbar spine, depending on suspected location)	Radiation, chemotherapy, surgery
Hernia (inguinal, femoral)	Groin pain	Hernia palpated in inguinal or femoral canal	None	Surgery
Infectious arthritis of the hip	Severe pain with recent onset, difficulty moving the hip, recent surgery, intravenous drug use	Pain with hip motion, guarding	Radiography, complete blood count, erythrocyte sedimentation rate, joint aspiration	Joint aspiration and irrigation, antibiotics
Intra-articular loose bodies	Hip pain with exercise; recent trauma or overuse	Hip pain with log roll or Patrick (FABER) test	Radiography, magnetic resonance arthrography	Arthroscopy
Lumbar spine pathology (e.g., T12-L2 disk herniation, degenerative disease)	Pain with walking or prolonged sitting; possible numbness, tingling, or weakness in lower extremities	Limited lumbar motion; normal hip examination; sensory or motor abnormalities in lower extremities; positive straight leg raise (possibly)	Radiography, MRI	Physical therapy, analgesics, surgery
Muscle strain	Pain early in exercise, recent increase in exercise	Tender muscle, pain with stretching and with resistance of the affected muscle	None	Ice, rest, physical therapy
Osteoarthritis	Pain radiating to the groin, stiffness, age older than 40 years	Pain with hip rotation or Patrick (FABER) test, limited range of motion late in disease process	Radiography	Physical therapy, analgesics, surgical hip replacement or resurfacing if refractory
Pelvic pathology (e.g., endometriosis, ovarian mass, colon cancer)	Pain unrelated to position or activity	Tenderness or mass on pelvic examination	Ultrasonography, CT, endoscopy, or laparoscopy as indicated	Treat the cause