Diagnosis: finding the cause of your hip symptoms

Hip symptoms in younger, active people often have a mechanical cause: something in the joint is catching, rubbing or tearing. To identify this, we combine three steps: a conversation about your symptoms, a physical examination and imaging.

Your orthopaedic surgeon will ask about the nature of your pain: where exactly it is, when it occurs and which movements make it worse. This is often groin pain that increases with prolonged sitting, deep bending or sport. During the physical examination, your surgeon checks the range of movement in your hip, using a few targeted tests in which the hip is bent and rotated.

An X-ray, and often an MRI too, show the shape of your hip and the condition of your labrum and cartilage. Sometimes a targeted injection into the hip is needed to confirm whether the hip is the source of your symptoms. The page on imaging explains exactly what each investigation involves and what to expect.

With FAI, the femoral head and hip socket meet each other slightly too early, causing the labrum to become pinched and sometimes leading to cartilage damage — particularly with the cam variant. This is the most common cause of hip symptoms in young, active people.

The labrum can also tear without FAI being present: through a single injury or through repeated overuse.

These include cartilage damage, a loose fragment of bone or cartilage in the joint (a 'loose body'), or hip dysplasia (a shallow hip socket). Read more about these on the page about other indications.

If your symptoms, examination findings and imaging all point the same way, we discuss together which treatment suits you best. Exercise therapy is almost always the first step; it's also often worthwhile to look at whether activities at work, in sport or in hobbies can be temporarily adjusted. If this doesn't help enough, hip arthroscopy may be an option.