Hip Joint Pain Referral Patterns: A Descriptive Study

Lesher, John M.; Dreyfuss, Paul; Hager, Nelson A.; Kaplan, Michael; Furman, Michael B.

doi:10.1111/j.1526-4637.2006.00153.x

Cited by 133 publications

(103 citation statements)

References 18 publications

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“…Although the number of segments in the human and rat differ slightly, the form of segmentation and structure of the spinal cord are similar in rats and humans. A few reports have described the anatomic sensory innervation [5] and pain referral pattern [10] of the hip. However, the precise sensory innervation pattern of the sensory nerve in the hip and inguinal skin is not clear.…”

Section: Discussionmentioning

confidence: 99%

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Differences in Innervation and Innervated Neurons between Hip and Inguinal Skin

Nakajima

Ohtori

Yamamoto

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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Pain originating from the hip may be referred to the groin and anterior thigh. We investigated sensory dorsal root ganglion neurons innervating the hip and the inguinal skin in rats using retrograde neurotransport and immunohistochemistry. A retrograde neurotracer FluoroGold TM was injected into the left hip or inguinal skin of rats. Seven days later, we harvested bilateral dorsal root ganglions and counted the number of Fluoro-Gold TMlabeled neurons positive for calcitonin gene-related peptide, a marker of nerve growth factor-dependent neurons, or isolectin B4, a marker of glial cell line-derived neurotrophic factor-dependent neurons. In the hip group, FluoroGold TM -labeled neurons were distributed throughout the left dorsal root ganglions from T13 to L5, primarily at L1, L2, L3, and L4, and the percentage of calcitonin generelated peptide-positive neurons was higher than that of isolectin B4-binding neurons. In the inguinal skin group, Fluoro-Gold TM -labeled neurons were distributed throughout the left dorsal root ganglions from T13 to L3, primarily at L1, L2, and L3, and the percentage of isolectin B4-binding neurons was higher than that of calcitonin gene-related peptide-positive neurons. These data suggest the sensory innervation pattern and characteristics of the sensory nerve of the rat hip are different from those of inguinal skin.

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Section: Discussionmentioning

confidence: 99%

“…However, referred pain may occur in the buttock, thigh, groin, leg, foot, and knee [10]. It is not clear why the symptoms and pain, along with inflammatory or degenerative processes, in the area of the hip are so varied.…”

Section: Introductionmentioning

confidence: 99%

Differences in Innervation and Innervated Neurons between Hip and Inguinal Skin

Nakajima

Ohtori

Yamamoto

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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“…Ipsilateral knee pain (IKP) is commonly associated with intraarticular hip disease [11,14,20,21,24,26] and other sources of pain referred from the lumbar spine and pelvic area. Osteoarthritis (OA) of the knee is not an uncommon cause of IKP [28].…”

Section: Introductionmentioning

confidence: 99%

“…Referred pain to the knee from hip disease is particularly common in the pediatric population and has been identified as a cause for delayed diagnosis of hip problems such as developmental dysplasia of the hip, Perthes' disease, slipped capital femoral epiphysis, septic arthritis, and others [14,18,27]. Others have reported a similar referred pain in adult patients with hip OA [8,21,24]. The accepted explanation of this phenomenon is that hips and knees get innervation from the femoral and obturator nerves.…”

Section: Introductionmentioning

confidence: 99%

Does Ipsilateral Knee Pain Improve after Hip Arthroplasty?

Wang

Geller

Nyce

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Intraarticular hip disease is commonly acknowledged as a cause of ipsilateral knee pain. However, this is based primarily on observational rather than highquality evidence-based studies, and it is unclear whether ipsilateral knee pain improves when hip disease has been treated. Questions/purposes We asked whether (1) hip disease was associated with preoperative ipsilateral knee pain and (2) ipsilateral knee pain would improve after hip arthroplasty. Patients and Methods We retrospectively assessed knee pain in 255 patients who underwent hip arthroplasties between 2006 and 2008. The WOMAC pain score of each joint was the primary outcome measure, which was obtained prospectively before surgery and at 3 months and 1 year postoperatively. Of the 255 patients, 245 (96%) had followup data obtained at 3 months or 1 year. Results Preoperatively, ipsilateral knee pain was observed more frequently than contralateral knee pain (55% versus 18%). Preoperative ipsilateral knee pain scores were worse than contralateral knee pain scores (mean, 80 versus 95). Ipsilateral knee pain improved at 3 months and 1 year. When compared with the scores for contralateral knee pain at 3 months (95) and 1 year (96), there were no differences between knees.

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“…Assessing hip and groin symptoms is complex because signs and symptoms from both regions often overlap and the pathology of either region often results in similar impairments (6,7). Impairments are defined according to the International Classification of Functioning, Disability and Health (ICF) as problems in body structure or function, such as a loss or significant deviation from normal values (8).…”

Section: Introductionmentioning

confidence: 99%

Clinimetric properties of observer‐assessed impairment tests used to evaluate hip and groin impairments: A systematic review

Dobson¹,

Choi²,

Hall³

et al. 2012

Arthritis Care & Research

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Objective. To recommend the most suitable observer-assessed impairment tests in people with hip and/or groin pathologies by conducting a systematic review of the clinimetric properties of these tests. Methods. Electronic searches were performed in the Cochrane, PubMed, CINAHL, Embase, SPORTDiscus, and PsycINFO databases up to August 2011. Two reviewers independently rated the measurement properties of clinical tests of impairments, defined by the International Classification of Functioning, Disability and Health as problems in body structure or body function, using the Consensus-Based Standards for the Selection of Health Status Measurement Instruments (COSMIN). "Best evidence synthesis" was made using COSMIN outcomes and the quality of findings was assessed using a purpose criteria system. Results. Fifteen of 2,588 publications were eligible for inclusion. Impairments evaluated were range of motion (ROM; 9 studies), muscle strength (6 studies), tenderness (3 studies), leg length discrepancy (2 studies), balance (2 studies), and muscle length (2 studies) in people with hip osteoarthritis (OA), hip fractures, and mixed hip/groin pathologies. Measurement properties evaluated included reliability, measurement error, construct validity, and criterion validity.

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Hip Joint Pain Referral Patterns: A Descriptive Study

Abstract: Buttock pain is the most common pain referral area from a symptomatic hip joint. Traditionally accepted groin and thigh referral areas were less common. Hip joint pain can occasionally refer distally to the foot. Lower lumbar spine referral did not occur.

Cited by 133 publications

References 18 publications

Differences in Innervation and Innervated Neurons between Hip and Inguinal Skin

Differences in Innervation and Innervated Neurons between Hip and Inguinal Skin

Does Ipsilateral Knee Pain Improve after Hip Arthroplasty?

Clinimetric properties of observer‐assessed impairment tests used to evaluate hip and groin impairments: A systematic review

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