A Layered Approach to Patient Evaluation With Prearthritic Hip Pain: History and Physical Examination
Due to the myriad etiologies of prearthritic hip pain, the history may be equally varied in regard to symptom onset, duration, and severity. In general, a history of a significant traumatic event is a good prognostic indicator of a potentially correctable problem, whereas insidious onset of symptoms can suggest highly correctable pathology or can be a poor prognostic indicator, suggesting underlying degenerative disease or predisposition to injury. 1 The location, quality, radiation, severity, and timing of symptoms are essential information to obtain. With any hip joint problem, the clinician must look closely for predisposing and palliative factors. For example, femoroacetabular impingement (FAI) is a recognized cause of joint breakdown in young adults. 1 Often, the cause may be multifactorial, including age, activity level, and joint morphology. Perhaps not all factors can be identified or corrected, but the evaluation must be thorough.
