Osteoarthritis or wear and tear of the joints mostly affects large load-bearing joints such as hips and knees. Joint pain is worse with standing or walking and improves with sitting or rest.
Hip arthritis presents with pain in the groin mainly in the front of the hip and sometimes in the side or back of the hip (buttock area).
Physical exam reproduces pain with hip internal rotation and distinct walking patterns are noticeable.
Hip X-rays are the best study to evaluate for osteoarthritis which can show bone spurs and decreased joint space. MRI may be needed if there is concern for additional soft tissue pathologies.
There are many different treatment options starting with modification of activity, ice, anti-inflammatories, strength training. It is important to lose weight, wear well cushioned shoes, and if necessary change to lower impact activities. Corticosteroid injections into the joints are best performed with image guidance such as fluoroscopy or ultrasound can reduce inflammation. If pain persists and severely limits activity, surgery including total joint replacement can provide significant benefit.