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.
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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 is an accurate diagnostic test 4.
Differential diagnosis
- peripheral vascular disease
- peripheral neuropathy, e.g. diabetic
- pelvic pathology, e.g. metastases, Paget disease, sacral insufficiency fracture, osteonecrosis 2
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