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Evaluation of Posterior Hip Pain

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Hip Arthroscopy and Hip Joint Preservation Surgery

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Abstract

The hip has an intimate biomechanical relationship with the spine, intra- and extra-pelvic structures, and the different etiologies of posterior hip pain reflect this relationship. Hip flexion and extension limitations lead to abnormal pelvis and spine biomechanics, expanding the hip-spine concept to hip-spine-pelvis-core. This chapter presents a structured diagnostic approach to evaluate all the following etiologies of posterior hip pain: primary deep gluteal syndrome, intra- and extra-pelvic; secondary deep gluteal syndrome, hip extension, flexion, or combined types; ischiofemoral impingement; greater trochanteric-ischial impingement; hamstring origin tear; hamstring syndrome; pudendal nerve entrapment; cluneal nerve entrapment; intermittent gluteal claudication; posterior hip joint abnormalities; sacroiliac joint, sacrum and related structures; and lumbar spine. The clinical examination and imaging findings associated with each etiology will be discussed in five sections: history, physical examination, imaging, injections, and additional studies. Our goal is to provide the reader with a structured approach to simplify the diagnosis of the complex presentation of posterior hip pain.

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Authors and Affiliations

  1. Hip Preservation Center, Baylor University Medical Center, Dallas, TX, USA

    Munif Hatem & Hal David Martin

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  1. Munif Hatem
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  2. Hal David Martin
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Editors and Affiliations

  1. Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA

    Shane J. Nho

  2. Department of Orthopedic Surgery, University of Michigan, Ann Arbor, MI, USA

    Bedi Asheesh

  3. Department of Orthopedic Surgery, Case Western Reserve University, Cleveland, OH, USA

    Michael J. Salata

  4. Department of Orthopedic Surgery, Duke Medical Center, Durham, NC, USA

    Richard C. Mather III

  5. Department of Orthopedic Surgery, Weill Medical College of Cornell Univers, New York, NY, USA

    Bryan T. Kelly

Section Editor information

  1. Houston Methodist Center for Orthopaedics & Sports Medicine, Houston, TX, USA

    Joshua D. Harris

  2. Rush University Medical Center, Chicago, IL, USA

    Joshua D. Harris

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Hatem, M., Martin, H.D. (2021). Evaluation of Posterior Hip Pain. In: Nho, S.J., Asheesh, B., Salata, M.J., Mather III, R.C., Kelly, B.T. (eds) Hip Arthroscopy and Hip Joint Preservation Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7321-3_175-1

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