Osteoarthritis of the Hip

A 70-year-old man reports a gradual onset of hip pain that has limited his activities for about a year. The pain initially occurred only with walking and was limited to the anterior hip area but now has spread to the side of the hip and is present at rest. He has no history of injury to the hip, back, or lower back and has no pain or morning stiff-ness in any other joints. He has been taking ibuprofen at a dose of 200 mg once or twice daily, without improvement. How should the patient be evaluated and treated? The Cl inic a l Problem Osteoarthritis is the most common joint disorder in the United States and is the lead-ing cause of disability in the elderly, with nearly 200,000 total hip replacements per-formed annually. Radiographic evidence of osteoarthritis of the hip is present in about 5 % of the population over the age of 65 years. However, not all patients with radiographic evidence of osteoarthritis have symptoms. The inconsistent relationship between radiographic changes and symptoms may account for discrepant findings in prevalence studies of osteoarthritis of the hip.1-3 The term “osteoarthritis ” is used to represent a heterogeneous group of joint dis