“Hip pain” comes from several places — the joint itself, the tendons and bursa on the outside of the hip, the muscles at the back, or a nerve. Each is treated differently, and only advanced joint wear needs replacement. Dr. Kiruthika distinguishes them by examination and ultrasound and treats each precisely.
The hip joint wears with age and load; its cartilage rim (labrum) can tear; the gluteal tendons and the bursa over the bony point of the hip become painful with weakness and overuse; the piriformis muscle can irritate the sciatic nerve; and a skin nerve at the front of the thigh is easily compressed by belts and posture. Groin pain usually means the joint; outer hip pain usually means tendon or bursa.
Examination to separate joint, tendon, muscle and nerve sources — and to exclude the back, which often refers pain to the hip. Ultrasound for tendons, bursa and joint fluid; X-ray for arthritis; MRI for labral tears and early avascular necrosis.
Conditions treated
Wear of the joint cartilage; groin pain, stiffness, reduced rotation. Ultrasound-guided intra-articular injection — steroid for flares, hyaluronic acid or PRP in earlier stages. Replacement is the right answer when bone-on-bone change limits walking and sleep.
Pain on the outer hip, worse lying on the side and climbing stairs, from the gluteal tendons and the bursa over the greater trochanter. Ultrasound-guided PRP or steroid injection, with a strengthening programme for the gluteal muscles.
A tear of the cartilage rim of the socket; deep groin pain with clicking or catching. An ultrasound-guided joint injection is both diagnostic and therapeutic; PRP in selected cases. Arthroscopic repair is discussed when mechanical symptoms persist in a young, active patient.
Loss of blood supply to the femoral head, often after steroid use or alcohol excess. In the earliest stages, regenerative injection (BMAC) may be considered alongside protected weight-bearing; established collapse needs orthopaedic surgery. Early diagnosis matters most.
The piriformis muscle in the buttock irritates the sciatic nerve; buttock pain radiating down the leg, worse on sitting. Ultrasound-guided injection into the muscle, with stretching.
Pain at the sitting bone where the hamstrings attach, worse on sitting and running. Ultrasound-guided PRP with a loading programme.
Burning or numbness on the outer thigh from compression of the lateral femoral cutaneous nerve, often by a belt, weight gain or pregnancy. Ultrasound-guided nerve block or hydrodissection, and removing the cause.
Fifteen to thirty minutes under ultrasound guidance. Hip joint injections are done with a longer needle under continuous ultrasound view and local anaesthesia; most patients walk out and drive.
Often. Buttock and outer thigh pain frequently comes from the lumbar spine or sacroiliac joint. Examination separates them.
For flares in moderate arthritis, yes, often by months. It does not reverse bone-on-bone wear.
Under ultrasound it is a controlled procedure; infection is rare. Steroid is not given within the three months before a planned replacement.
Pressure on the gluteal tendons and bursa over the bony point of the hip — gluteal tendinopathy, not usually the joint.
For groin pain that does not settle, or where a labral tear or avascular necrosis is suspected. Not for outer hip pain, which ultrasound assesses fully.