THE PAINFUL HIP: DIAGNOSIS AND DELIVERANCE

Pain following total hip arthroplasty is a relatively rare event. Several series place the incidence of some degree of pain post THA at approximately 5%.A systematic approach to determining etiology will direct treatment. Hip pain can be categorised as:Extrinsic to the Hip–Spine +/− radiculopathy–Vascular disease–Metabolic (Paget's)–MalignancyIntrinsic to the HipIntracapsular/ImplantLooseningSepsisProsthetic failureOsteolysisInstabilityThigh painStem tip painHypersensitivity/ALVALExtracapsularIliopsoas tendonitisSnapping HipTrochanter problems (bursitis)Heterotopic ossificationA full history and appropriate physical exam will direct the clinician. The use of routine radiographs, blood tests, and special tests (i.e., blood metal ions, advanced imaging techniques) will be discussed I detail.