Osteoarthritis (OA) of the hip is the second most common presentation of OA after the knee. It accounts for significant morbidity and total hip replacement is now one of the most common operations performed in the developed world.

Risk factors

• increasing age
• female gender (twice as common)
• obesity
• developmental dysplasia of the hip

PC

• chronic history of groin ache following exercise and relieved by rest
  • OA of the hip can present as knee pain
• red flag features suggesting an alternative cause include rest pain, night pain and morning stiffness > 2 hours

the Oxford Hip Score is widely used to assess severity

Investigations

• NICE recommends that if the features are typical then a clinical diagnosis can be made
• otherwise plain x-rays are the first-line investigation

Management

• oral analgesia
• intra-articular injections: provide short-term benefit