title: Differentiating Hip Pathology From Lumbar Spine Pathology: Key Points of Evaluation and Management.
abstract: The diagnosis and treatment of patients who have both hip and lumbar spine pathologies may be a challenge because overlapping symptoms may delay a correct diagnosis and appropriate treatment. Common complaints of patients who have both hip and lumbar spine pathologies include low back pain with associated buttock, groin, thigh, and, possibly, knee pain. A thorough patient history should be obtained and a complete physical examination should be performed in these patients to identify the primary source of pain. Plain and advanced imaging studies and diagnostic injections can be used to further delineate the primary pathology and guide the appropriate sequence of treatment. Both the surgeon and the patient should understand that, although one pathology is managed, the management of the other pathology may be necessary because of persistent pain. The recognition of both entities may help reduce the likelihood of misdiagnosis, and the management of both entities in the appropriate sequence may help reduce the likelihood of persistent symptoms.
authors.affiliation: From the NYU Hospital for Joint Diseases, New York, NY (Dr. Buckland, Dr. Slover and Dr. Razi), Fair Oaks Orthopaedics, Fairfax, VA (Dr. Miyamoto), and the Department of Orthopaedic Surgery, University of Michigan Health System, Ann Arbor, MI (Dr. Patel).
authors.forename: Aaron J
authors.initials: AJ
authors.lastname: Buckland
authors.forename: Ryan
authors.initials: R
authors.lastname: Miyamoto
authors.forename: Rakesh D
authors.initials: RD
authors.lastname: Patel
authors.forename: James
authors.initials: J
authors.lastname: Slover
authors.forename: Afshin E
authors.initials: AE
authors.lastname: Razi
mesh_terms: D003937:Diagnosis, Differential; D006621:Hip Joint; D006801:Humans; D007592:Joint Diseases / Q000175:diagnosis*; D008159:Lumbar Vertebrae; D008487:Medical History Taking; D010808:Physical Examination; D011859:Radiography