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Hip Osteoarthritis Cheat Sheet (DRAFT) by

Presentation, Management etc

This is a draft cheat sheet. It is a work in progress and is not finished yet.


- Repetitive microt­rauma irritates the cartilage
- Immune response causes swelling and softening
- Surface damage occurs
- Subcho­ndral cysts, joint space narrowing, sclerosis , deformity and osteop­hytes in chronic cases


- Age
- Repetitive trauma (prolonged standi­ng/­sit­ting), heavy physical exertion)
- Obesity
- Male gender
- Congenital defects


- Prolonged stiffness upon arising (<60 mins) and inactivity
- Inability to put their socks on, shave their legs, climb stairs
- Groin, anterior thigh and buttock pain
- C Sign (Index finger over anterior aspect of hip, near ASIS and thumb over posterior trocha­nteric region when they point to their area of pain
- Pain below the knee can indicate saphenous nerve involv­ement
- Pain gradually progre­ssive from dull to sharp and increases with weight bearing
- Crepitus can be present
- TTP over GT
- ROM Diminished in capsular pattern (PROM >15 degrees in internal rot, >155 in hip flexion)
- AROM flexion and extension painful
- Tight ilipsoas, adductors, QL, TFL, piriformis
- Weak gluts, Quads, external rotators of the hip
- +ve Trende­leburg, FABRE, Quadrant, FAIR, Thomas
-HOOS for symptoms and disability


- Standard for Hip OA:
if >65 years old
Severe pain
Hx of trauma
Cortic­ost­eroid use
Alcohol abuse (AVN)
Aspher­icity of the femoral head on x-ray = AVN MRI NEEDED
Any red flags
Blood tests (ESR, FBC, CRP, RF, ANA, WBCC) for infect­ion­/in­fla­mmatory arthro­pathy


- EMT of the hip
- SMT/EMT of Lx, SI, LL
- Swimming, cycling, walking on safe and flat surfaces
- Stretching of psoas, adductors, quads, TFL and piriformis
- Streng­thening of gluts, quads, ext rots of the hip, hup adductors, hip flexors and core muscles
- Lifestyle recomm­end­ations - avoid aggrav­ating activities (require internal rotation) , overweight patients weight reduction program
- Temporary cane in opposite hand
- NSAIDs­/1500mg of glucos­amine and chondr­oitin