When you go to your orthopaedic surgeon, he will take several steps to make the diagnosis. While the presence of an arthritic hip may seem obvious to you, your surgeon will need to evaluate your hip to make sure the diagnosis is correct. First, he will take a history of your problem. He or she will want to know where you have pain, how long it has been present and when it started. He will want to know if the pain developed on its own or came after an injury.
He may ask you what part of your hip or your leg hurts and what movements make it hurt. Tell your surgeon if you are limping or you are having trouble walking. He will ask if you have difficulty with certain activities such as bending over, tying your shoes or going up and down stairs. Tell him how much pain medicine you take and whether anything makes the pain better or worse. Part of your history includes any hip problems or injury in the past.
Your surgeon will want to know if you have had childhood hip disease, a fracture, or some other condition that might cause pain in your hip. He will also want to hear about any condition that causes arthritis throughout your body. You should also discuss your family history. If, for example, both your mother and grandmother had arthritis in their hips, then you might be suffering from a similar problem. When your surgeon completes the history, he will do a physical examination.
This involves checking for tenderness or deformity around your hip. He will test the range of motion of your hip joint, evaluate the strength in your leg, and watch how you stand and walk. He may also look at other areas such as your spine which could cause pain in your hip. In addition to history and physical examination, an x-ray will help make the diagnosis. If the disease is far enough advanced, an x-ray will show the changes of an arthritic hip.
It may also provide a clue as to what has caused the arthritis such as an old fracture or a child-hood hip problem. An x-ray along with your history and physical findings will most often confirm the diagnosis. Sometimes, the plain x-ray may not show the problem. When this happens, the surgeon may choose to obtain a Magnetic Resonance Imaging study, or MRI.MRI can show a stress fracture or avascular necrosis when the early changes are not always evident on a plain film.
Your surgeon may order a blood test to rule out a systemic problem such as rheumatoid arthritis. Other blood tests might help diagnose problems such as infection, lupus, or ankylosing spondylitis. Finally, he may ask that you have an aspiration done to retrieve fluid from your hip. This is done by a radiologist under x-ray guidance. A sample of the hip joint fluid would be taken and sent to the laboratory for evaluation and for culture to make sure that there is no infection.
Once your doctor has made the diagnosis of an arthritic hip, he will present you with the range of treatment options.