DOS Kongressen 2014 ·
207
Pain distribution in primary care patients with hip
osteoarthritis – a descriptive study
Erik Poulsen, Søren Overgaard, Jacob Toft Vestergaard,
Henrik Wulff Christensen, Jan Hartvigsen
Research, Nordic Institute of Chiropractic and Clinical Biomechanics;
Department of Orthopaedic Surgery and Traumatology, Odense University
Hospital; Department of Sports Science and Clinical Biomechanics, University
of Southern Denmark
Background:
When adult patients present in primary care with hip pain, the
most common diagnosis is hip osteoarthritis (OA). A number of studies have
reported pain location and distribution in hip OA patients but findings relate
to patients just prior to total hip arthroplasty (THA) and include patients with
rheumatoid arthritis, osteonecrosis and severe dysplasia. A single study has ex-
amined pain location in primary care patients with hip pain but 2/3 of the pa-
tients did not have hip OA.
Purpose / Aim of Study:
To describe pain location and pain distribution in a
cohort of primary care patients with unilateral hip OA.
Materials and Methods:
Primary care patients with unilateral early to moder-
ate clinical and radiographic hip OA recorded distribution of hip pain on a manikin
displaying three separate planes: frontal, back and lateral views. Pain drawings
were analysed using a template and drawings were subsequently digitally pro-
cessed to produce a composite image.
Findings / Results:
A total of 109 patients completed pain drawings. The mean
age was 65 (SD 9), 44% were females, the right/left hip ratio was 66/43 re-
spectively, the mean pain duration was 32 months (SD 36, range 4 – 300), and
mean pain intensity was 5.4 (SD 2.0). A minority of patients reported pain in
only one area, most commonly the greater trochanter area (16%). No patients
marked pain exclusively in the areas of the knee, posterior thigh or lower leg.
Conclusions:
The most common pain locations of symptomatic hip OA pre-
senting in primary care are the greater trochanter, groin, thigh and buttock ar-
eas. When adult patients in primary care present with pain in the greater tro-
chanter, groin, anterior lateral thigh or buttock areas, the clinician as a minimum
should include a physical examination of the hip joint.
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