Diagnosis of hip pathologies
Diagnosing hip conditions is a crucial step in determining the appropriate treatment and ensuring optimal recovery. Several diagnostic methods are used to assess the condition of the hip joint, but it always starts with an exchange with the surgeon. It is followed by a clinical examination and possibly additional medical imaging exams. This article details the various diagnostic methods for hip pathologies.
.png)
PR Nicolas Reina
Head of the Hip and Traumatology Department
.webp)
Professor Nicolas Reina
Degenerative pathology and osteoarthritis
Traumatic pathology
Athlete pathology
Welcome to the site of Professor Nicolas Reina, specialist in hip surgery. With recognized expertise in this field, Professor Reina provides high quality care to patients suffering from hip pathologies.
Interview with the patient
In order to understand pain, functional discomfort, and the impact on daily life, interviewing the patient is essential. The medical history and the symptoms experienced often provide diagnostic guidance. The doctor will ask questions about the pain, its location, severity, and circumstances under which it occurs. It is also important to know the patient's medical history, including previous injuries and chronic illnesses.
During this interview, it is important that you express your questions and concerns about possible surgery. The trust aspect is crucial. Numerous scientific publications demonstrate that this allows for better clinical results after surgery.
Clinical examination
Clinical examination is the first step in diagnosing hip pathologies. It provides valuable information about the symptoms and physical condition of the patient. It also makes it possible to establish the origin of the pain. Some groin pain may come from inginal hernias or abdominal or gynecological pain. Also, joint pain can be associated with periarticular pain such as bursitis (trochanteric pain), tendon pain (psoas muscle tendon, anterior right tendon) or muscular pain (gluteus medius muscle, priformis) pain.
Physical Exam
The physical exam includes several tests to assess the mobility, strength, and stability of the hip joint. The doctor may ask the patient to perform various movements to identify pain areas and movement limitations. This examination makes it possible to detect visible signs when walking or when examining the articular amplitudes of the hip but also of the spine or the knee because there are major interactions between the static, the junction between the spine and the pelvis.
Specific tests
Some specific tests can be carried out to detect particular pathologies:
FADIR test: Maneuver in flexure and internal rotation of the hip. It makes it possible to detect femoro-acetabular conflicts by reproducing painful movements.
Trendelenburg test: Evaluates hip stability and abductor muscle strength. The patient stands on one leg and the doctor observes the position of the pelvis.
Faber (or Patrick) test: Helps identify sacroiliac joint or hip problems. The patient lies on his back with one leg bent and placed on the other knee.
These tests will be completed according to the symptoms of each patient.
Medical imaging
Medical imaging techniques play a crucial role in the diagnosis of hip pathologies. They make it possible to visualize the internal structures of the joint and to identify anomalies.
X-ray
Pelvic radiography is often the first imaging technique used. It allows hip bones to be visualized and anomalies such as osteoarthritis, fractures or birth defects to be detected. Standard x-rays generally include anteroposterior and lateral views. This technique is fast and widely available, making it a very useful initial diagnostic tool.
Computed tomography (CT or CT scan)
Computed tomography offers detailed images of bone structures and soft tissue. It is particularly useful for evaluating complex fractures, tumors, or bone abnormalities. The scanner also makes it possible to plan surgical procedures with great precision in order to specify bone deformations. This exam is often used when more detailed information is needed beyond what an x-ray can offer. By combining an intraarticular injection of contrast medium, arthroscanner makes it possible to specify cartilage or labrum lesions.
Magnetic Resonance Imaging (MRI)
Magnetic resonance imaging is a non-invasive method that uses magnetic fields to produce detailed images of soft tissue and internal structures. MRI is particularly useful for diagnosing cartilage damage, ligament tears, tendonitis, and femoroacetabular conflicts. This exam is preferred for its ability to provide highly accurate images of soft tissue and internal abnormalities.
Ultrasound
Ultrasound is an imaging technique that uses sound waves to visualize the soft tissue around the hip joint. It is often used to diagnose bursitis, tendonitis, and to guide therapeutic injections. Ultrasound is also useful for evaluating movements in real time and for diagnosing dynamic conditions.
Laboratory tests
Laboratory tests can be used to complete the diagnosis of hip pathologies, especially in cases of suspected infection or inflammatory diseases.
Blood analysis
A blood test can detect signs of infection, inflammation, or other metabolic abnormalities. Specific markers such as C-reactive protein (CRP) and erythrocyte sedimentation rate (VSE) may indicate inflammation. Other blood tests may be done to assess kidney and liver function, and to detect autoimmune diseases.
Joint puncture
Joint puncture involves taking a sample of synovial fluid from the hip joint for analysis. This can help diagnose infections, crystals (such as in gout), or inflammatory conditions. The puncture is carried out under sterile conditions to avoid contamination and the samples are sent for microbiological, cytological and chemical analysis.
Importance of an accurate diagnosis
An accurate diagnosis of hip pathologies is essential to determine the appropriate treatment and ensure optimal recovery. A wrong or incomplete diagnosis can lead to inappropriate treatments and worsening of symptoms.
Multidisciplinary collaboration
Diagnosing hip conditions often involves collaboration between several specialists, including orthopedists, radiologists, and rheumatologists. This multidisciplinary approach, allowed in a major center and its technical platform, makes it possible to obtain a complete and accurate assessment of the condition of the hip.