Stubbs Allston Julius, Atilla Halis Atil
Department of Orthopaedics, Wake Forest University Baptist Medical Center, Winston Salem, USA.
Muscles Ligaments Tendons J. 2016 Dec 21;6(3):300-308. doi: 10.11138/mltj/2016.6.3.300. eCollection 2016 Jul-Sep.
Despite the rapid advancement of imaging and arthroscopic techniques about the hip joint, missed diagnoses are still common. As a deep joint and compared to the shoulder and knee joints, localization of hip symptoms is difficult. Hip pathology is not easily isolated and is often related to intra and extra-articular abnormalities. In light of these diagnostic challenges, we recommend an algorithmic approach to effectively diagnoses and treat hip pain.
In this review, hip pain is evaluated from diagnosis to treatment in a clear decision model. First we discuss emergency hip situations followed by the differentiation of intra and extra-articular causes of the hip pain. We differentiate the intra-articular hip as arthritic and non-arthritic and extra-articular pain as surrounding or remote tissue generated. Further, extra-articular hip pain is evaluated according to pain location. Finally we summarize the surgical treatment approach with an algorithmic diagram.
Diagnosis of hip pathology is difficult because the etiologies of pain may be various. An algorithmic approach to hip restoration from diagnosis to rehabilitation is crucial to successfully identify and manage hip pathologies. Level of evidence: V.
尽管髋关节成像和关节镜技术迅速发展，但漏诊情况仍然常见。作为一个深部关节，与肩关节和膝关节相比，髋关节症状的定位较为困难。髋关节病变不易孤立存在，且常与关节内和关节外异常相关。鉴于这些诊断挑战，我们推荐一种算法方法来有效诊断和治疗髋关节疼痛。
在本综述中，髋关节疼痛从诊断到治疗在一个清晰的决策模型中进行评估。首先，我们讨论髋关节急症，然后区分髋关节疼痛的关节内和关节外原因。我们将关节内髋关节分为关节炎性和非关节炎性，将关节外疼痛分为周围组织或远处组织产生的疼痛。此外，根据疼痛部位评估关节外髋关节疼痛。最后，我们用算法图总结手术治疗方法。
髋关节病变的诊断困难，因为疼痛病因可能多种多样。从诊断到康复的髋关节恢复算法方法对于成功识别和管理髋关节病变至关重要。证据级别：V级。
