Differential diagnosis of hip pain

Pain over the anterior part of the thigh/around the groin can be from the femoral nerve, which can be caused by problems with the third and fourth lumbar segments.  To diagnose this, do a spinal examination and the femoral nerve stretch test, which is done by lying the patient prone and extending the hip with the knee in flexion.  Check the SLR for completeness while you’re at it.

Pain felt anteriorly and just lateral to the femoral canal can also be due to a psoas sprain (particularly likely in sprinting, kicking, and high knee-lift exercises).  If the psoas bursa is inflamed, passive hip flexion will also be painful.

And numbness over the anterior thigh can be due to entrapment of the lateral cutaneous nerve as it emerges from the superficial fascia (a condition known as meralgia paraesthetica).  Tight clothing can cause similar symptoms.

(This comes from an article in Pulse, 5th October.)

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About Dr Sarah

I'm a GP with a husband and two young children.
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