[Medical Q&A] Does hip pain in the elderly mean femoral head necrosis?

Planner: Chinese Medical Association

Reviewer: Zhang Xin, deputy chief physician, Peking University Third Hospital

If elderly people experience unexplained hip pain, it may not necessarily be femoral head necrosis, but may also be hip impingement syndrome.

Femoral head necrosis refers to a lack of blood supply to the femoral head, which causes bone cells to die, resulting in pain and joint dysfunction. This condition is usually associated with clear risk factors, such as alcohol abuse, long-term corticosteroid use, fractures or joint replacement surgery.

Hip impingement syndrome is a disease caused by abnormal hip joint structure. Simply put, some people have abnormal bony protrusions in the junction area of ​​the acetabulum and femoral head and neck (the bone between the femoral head and the femoral trochanter) of the hip joint. These bony protrusions can cause collision between the acetabulum and the femoral head and neck junction, thereby causing labral injury and osteoarthritis of the hip joint, leading to pain.

The pain caused by hip impingement syndrome is mostly chronic pain in the hip joint, and some patients may have limited mobility. The pain is mostly dull pain and joint soreness. Some patients also experience pain in the knee joint, lower back and sacroiliac joint area, but it rarely affects the area below the knee joint and above the waist. Symptoms may worsen or recur when patients walk for a long time, squat, lift their legs, stand up after sitting for a long time, or exercise vigorously.

Therefore, if hip pain occurs, you should seek medical attention immediately. A professional doctor will determine the specific cause through detailed interviews, physical examinations, and necessary imaging examinations (such as X-rays and MRI). The doctor will ask about the specific location of the pain, the nature (such as whether it is continuous or intermittent), and the factors that aggravate or relieve it. Based on the diagnosis results, the doctor will give corresponding treatment recommendations, including medication, physical therapy, rehabilitation exercises, etc.