Hip spine syndrome
Updates to Article Attributes
Hip spine syndrome is one term used to describe the clinical association between hip osteoarthritis and degenerative lumbar spinal canal stenosis due to overlapping pain distribution.
Clinical presentation
Patients with hip spine syndrome have hip and lumbar spine degeneration and present with buttock, thigh and/or knee pain 2. Groin and/or buttock pain are thought to be specific markers for hip pathology 1,2.
Pathology
Classification
Hip spine syndrome has been classified into four types 1,3:
- simple (primary): symptomatic hip and lumbar pathology but straightforward clinical differentiation
- secondary: symptomatic hip and lumbar pathology where one has caused the other
- complex: symptomatic hip and lumbar pathology but clinical identification of the source of pain is not possible
- misdiagnosed: hip and lumbar pathology with inappropriate treatment resulting in ongoing symptoms
Treatment and prognosis
In patients with hip-spine syndrome where the pain source cannot be identified, an image-guided hip joint injection can be used as ais an accurate diagnostic test 4.
Differential diagnosis
- peripheral vascular disease
- peripheral neuropathy, e.g. diabetic
- pelvic pathology, e.g. metastases, Paget disease, sacral insufficiency
fracturesfracture, osteonecrosis 2
-<p><strong>Hip spine syndrome</strong> is one term used to describe the clinical association between <a title="Hip osteoarthritis" href="/articles/osteoarthritis-of-the-hip">hip osteoarthritis</a> and degenerative <a title="Lumbar spinal canal stenosis" href="/articles/lumbar-spinal-canal-stenosis">lumbar spinal canal stenosis</a> due to overlapping pain distribution. </p><h4>Clinical presentation</h4><p>Patients with hip spine syndrome have hip and lumbar spine degeneration and present with buttock, thigh and/or knee pain <sup>2</sup>. Groin and/or buttock pain are thought to be specific markers for hip pathology <sup>1,2</sup>. </p><h4>Pathology</h4><h5>Classification</h5><p>Hip spine syndrome has been classified into four types <sup>1,3</sup>:</p><ul>- +<p><strong>Hip spine syndrome</strong> is one term used to describe the clinical association between <a href="/articles/osteoarthritis-of-the-hip">hip osteoarthritis</a> and degenerative <a href="/articles/lumbar-spinal-canal-stenosis">lumbar spinal canal stenosis</a> due to overlapping pain distribution. </p><h4>Clinical presentation</h4><p>Patients with hip spine syndrome have hip and lumbar spine degeneration and present with buttock, thigh and/or knee pain <sup>2</sup>. Groin and/or buttock pain are thought to be specific markers for hip pathology <sup>1,2</sup>. </p><h4>Pathology</h4><h5>Classification</h5><p>Hip spine syndrome has been classified into four types <sup>1,3</sup>:</p><ul>
-</ul><h4>Treatment and prognosis</h4><p>In patients with hip-spine syndrome where the pain source cannot be identified, an image-guided intra-articular <a title="Hip injection (disambiguation)" href="/articles/hip-injection-disambiguation">hip injection</a> can be used as a diagnostic test <sup>4</sup>. </p><h4>Differential diagnosis</h4><ul>-<li>peripheral vascular disease</li>- +</ul><h4>Treatment and prognosis</h4><p>In patients with hip-spine syndrome where the pain source cannot be identified, an image-guided <a title="Hip joint injection (technique)" href="/articles/hip-joint-injection-technique">hip joint injection</a> is an accurate diagnostic test <sup>4</sup>. </p><h4>Differential diagnosis</h4><ul>
- +<li><a title="Peripheral vascular disease" href="/articles/peripheral-arterial-disease">peripheral vascular disease</a></li>
-<li>pelvic pathology, e.g. metastases, Paget disease, sacral insufficiency fractures, osteonecrosis<sup> 2</sup>- +<li>pelvic pathology, e.g. <a title="Skeletal metastasis" href="/articles/skeletal-metastasis-1">metastases</a>, <a title="Paget disease (bone)" href="/articles/paget-disease-bone">Paget disease</a>, <a title="Sacral insufficiency fractures" href="/articles/sacral-insufficiency-fracture-1">sacral insufficiency fracture</a>, <a title="Osteonecrosis" href="/articles/osteonecrosis-2">osteonecrosis</a><sup> 2</sup>
References changed:
- 1. Younus A & Kelly A. Hip Spine Syndrome – A Case Series and Literature Review. Interdisciplinary Neurosurgery. 2021;23:100960. <a href="https://doi.org/10.1016/j.inat.2020.100960">doi:10.1016/j.inat.2020.100960</a>
- 2. Devin C, McCullough K, Morris B, Yates A, Kang J. Hip-spine Syndrome. J Am Acad Orthop Surg. 2012;20(7):434-442. <a href="https://doi.org/10.5435/jaaos-20-07-434">doi:10.5435/jaaos-20-07-434</a>
- 3. Prather H & Dillen L. Links Between the Hip and the Lumbar Spine (Hip Spine Syndrome) As They Relate to Clinical Decision Making for Patients with Lumbopelvic Pain. PM&R. 2019;11(S1). <a href="https://doi.org/10.1002/pmrj.12187">doi:10.1002/pmrj.12187</a>
- 4. Maldonado D, Mu B, Ornelas J et al. Hip-Spine Syndrome: The Diagnostic Utility of Guided Intra-articular Hip Injections. Adv Orthop. 2020;43(2). <a href="https://doi.org/10.3928/01477447-20191223-05">doi:10.3928/01477447-20191223-05</a>
Tags changed:
- cases
Sections changed:
- Syndromes
Systems changed:
- Musculoskeletal
- Spine