Fernandez Miguel, Wall Peter, O'Donnell John, Griffin Damian
MBBS, MRCS (Eng), PhD, Academic Clinical Fellow in Trauma and Orthopaedic Surgery, University Hospitals Coventry and Warwickshire NHS Trust and Warwick Orthopaedics, University of Warwick, UK.
Aust Fam Physician. 2014 Apr;43(4):205-9.
Traditionally, the management of hip pain has been well defined by age groups such as the limping child and older patients with symptomatic osteoarthritis (OA). However, young adults (typically aged 16-50 years) with persistent hip pain who do not have OA or a childhood hip disorder have presented a diagnostic challenge and their management less well defined.
We present a clinical review intended as a guide for general practitioners to aid the identification of such patients through focused history taking and examination. We outline the primary care management and provide guidance on when to refer.
Our understanding of the causes of hip pain in young adults has increased significantly over the last decade. This has led to the recognition that subtle hip shape abnormalities, termed femoroacetabular impingement, can cause symptomatic soft tissue damage and may initiate OA. This is important as it now raises the possibility of identifying and treating young adults with pre-arthritic symptoms (the 'at-risk' hip).
传统上，髋部疼痛的管理已根据年龄组进行了明确界定，如跛行儿童和有症状性骨关节炎（OA）的老年患者。然而，没有骨关节炎或儿童期髋部疾病但持续存在髋部疼痛的年轻成年人（通常年龄在16 - 50岁之间）带来了诊断挑战，且对他们的管理界定得不太明确。
我们进行了一项临床综述，旨在为全科医生提供指导，通过有针对性的病史采集和检查来帮助识别这类患者。我们概述了初级保健管理，并提供何时转诊的指导。
在过去十年中，我们对年轻成年人髋部疼痛原因的理解有了显著提高。这导致人们认识到，被称为股骨髋臼撞击症的细微髋部形状异常可导致有症状的软组织损伤，并可能引发骨关节炎。这很重要，因为它现在增加了识别和治疗有骨关节炎前期症状（“高危”髋部）的年轻成年人的可能性。
