Can my hip really be causing my knee pain?

Why the brain gets the location wrong

The obturator and femoral nerves carry sensation from both the hip joint and the inner and front part of the knee. When the hip is irritated, the brain can interpret the signal as coming from the knee. The result is a real pain in the knee area, even though the knee itself may be healthy.

Clues that point to the hip

• Pain in the groin, the front of the thigh or the buttock as well as the knee
• Stiffness putting on socks and shoes or cutting toenails
• Difficulty getting in and out of a car, or crossing your legs
• A limp, or pain when you first stand up after sitting
• Knee pain without swelling, clicking, locking or tenderness of the knee joint
• Knee X-rays or MRI that do not explain how much it hurts

In Qatar, many patients first notice it when kneeling or sitting on the floor becomes difficult, since these positions need good hip movement too.

Which hip problems do this

• Hip osteoarthritis, the most common cause in adults over about 50
• Avascular necrosis of the hip, where part of the ball loses its blood supply
• Hip impingement or labral problems in younger, active adults
• In children and teenagers, Perthes disease and a slipped upper femoral growth plate

The knee and hip can of course both be affected at once, which is common in arthritis.

How it is checked in Doha

A careful knee consultation always includes the hip. At Aman Hospital Dr. Gelber examines hip rotation, which often reproduces the familiar knee pain if the hip is the source, and arranges a pelvic or hip X-ray when needed. If the hip is the main cause, he will explain the findings and refer you to a hip specialist, so that you do not undergo knee treatment that will not help.