1. Rheumatoid Arthritis Slideshow Pictures
2. Take the RA Quiz
3. Understanding Lupus Slideshow Pictures

Medical Author:

Benjamin Wedro, MD, FACEP, FAAEM

Benjamin Wedro, MD, FACEP, FAAEM

Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

View Full Profile

Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

View Full Profile

Hip Fracture

Falls are the most common reason that elderly people break a hip. The fracture is due to a combination of two effects of aging, osteoporosis (thinning of bones) and a loss of balance. These two risk factors often precipitate many falls. Occasionally, the bone may spontaneously break due to osteoporosis and become the cause of the fall.

When health-care practitioners talk about a hip fracture, they really mean a fracture of the proximal or upper part of the femur.

The precise location of the fracture is important, because it guides the decision of the orthopedic surgeon as to which type of operation is needed to repair the injury.

Aside from a fall, any trauma can potentially cause a hip fracture. Depending upon the mechanism of injury, the femur may not break; rather, a portion of the pelvis (often the pubic ramus) may be fractured. The initial pain may be in the hip area, but examination and X-rays may reveal a different source of the injury. Trauma can also cause a hip dislocation in which the femoral head loses its relationship with the acetabulum. This is almost always associated with an acetabular (pelvic bone) fracture; however, in patients with hip replacements, the artificial hip may dislocate spontaneously.

Picture of the Location of Most Hip Fractures

Contusions (Bruises)

Contusions (bruises), sprains, and strains may occur as a result of trauma, and even though there is no broken bone, these injuries can still be very painful. Sprains are due to ligament injuries, while strains occur because of damage to muscles and tendons. Because of the amount of force required to walk or jump, the hip joint is required to support many times the weight of the body. The muscles, bursas, and ligaments are designed to shield the joint from these forces. When these structures are inflamed, the hip cannot function and pain will occur.

Overuse Injuries

Hip pain may also arise from overuse injuries in which muscles, tendons, and ligaments can become inflamed. These injuries may be due to routine daily activities that may cause undue stress on the hip joint or because of one specific strenuous event. Overuse may also cause gradual wearing away of the cartilage in the hip joint, causing arthritis (arth=joint + itis=inflammation).

Other structures should be mentioned as a cause of hip pain because they become inflamed. The iliotibial band stretches from the crest of the pelvis down the outside part of the thigh to the knee. This band of tissue may become inflamed and cause hip pain, knee pain, or both. This is a type of overuse injury that has a gradual onset associated with tightness of the muscle groups that surround the knee and hip. Piriformis syndrome, in which the piriformis muscle irritates the sciatic nerve in the buttock, can also cause significant posterior hip pain.

Bursa Inflammation (Hip Bursitis)

The trochanteric bursa is a sac on the outside part of the hip that serves to protect muscles and tendons as they cross the greater trochanter (a bony prominence on the femur). Trochanteric bursitis describes the inflammation of this bursa. The bursa may become inflamed for a variety of reasons, often due to minor trauma or overuse.

Must Read Articles Related to Hip Pain

Bursitis Bursae (one is a bursa) are fluid-filled sacs that cushion areas of friction between tendon and bone or skin. Like air-filled bubble wrap, these sacs reduce fri...learn more >>

Fibromyalgia Fibromyalgia is an illness with no known cause. Symptoms include chronic pain, fatigue, fibrofog (mental haziness), insomnia, headaches, nervousness, numbness, ...learn more >>

Minimally Invasive Hip Replacement Minimally invasive hip replacement is surgery performed with smaller incisions, which reduces the trauma to the tissue, reduces pain, and shortens recovery time...learn more >>

See the Entire Hip Pain Topic Guide »