'Hip pain' covers an incredibly broad range of potential diagnoses. Pain in the hip joint has many potential causes including: arthritis, loose bodies, stress fracture, transient ischemic necrosis, slipped capital epiphysis, Perthes, osteonecrosis, labral tear and, in rare situations, infection.
Pain in the 'hip area' can arise from low back disorders and is termed 'referred pain', the same way that angina of the heart can present as left arm pain even though the arm is completely normal. Other causes of pain around the 'hip area' which are not necessarily coming from the joint itself include trochanteric bursitis, strains or tears of the abductor muscles, iliopsoas tendonitis, rectus tendonitis, and impingement occurring outside the joint, just to name a few. The nature, location, type and duration of the hip pain give valuable clues. A careful physical exam, including range of motion testing, specific diagnostic tests, measurement of leg lengths, and interpretation of x-rays and MRI's are essential to establishing a correct diagnosis. Analysis of the way a patient walks (gait analysis) is very important. For instance, hip pain is frequently associated with limping, whereas, referred pain from the back is usually not.
It is important to emphasize that every abnormality on an x-ray does not mean that a surgical solution is necessary. Experienced hip surgeons are careful to recommend surgery only when medically necessary and supported by sound clinical and objective evidence.