How do doctors tell if knee pain is coming from the hip or back?

The history: what your description reveals

Pain that starts in the buttock or back and travels down the leg points to the spine. Pain in the groin and front of the thigh, worse with putting on socks, points to the hip. Pain that you can cover with one finger on the knee, with swelling, clicking or locking, points to the knee. Tingling, numbness or a feeling of weakness suggests a nerve.

The examination

• Hip rotation: turning the bent hip inwards often reproduces the knee pain when the hip is the source
• Walking and standing on one leg: a limp or dipping pelvis suggests hip weakness or arthritis
• Spine and nerve tests: back movement, the straight leg raise, reflexes, sensation and muscle strength
• Knee tests: tenderness along the joint line, swelling, kneecap tracking, ligament and meniscus tests
• Comparing with the other leg, and checking the pulses and calf

Tests that confirm the source

• X-ray of the pelvis or hip when hip arthritis is suspected
• Standing knee X-rays to assess the knee fairly
• MRI of the lower spine if a nerve root is suspected
• Nerve conduction studies in selected cases
• A diagnostic local anaesthetic injection into the hip or knee: if the pain disappears for a few hours, that joint is likely the source

What to expect at Aman Hospital

Wear shorts or loose clothing so the hips and knees can be examined, and bring any previous scans. Dr. Gelber examines the back, hips and knees in one visit, explains which structure he thinks is responsible, and only then suggests tests. If the hip or spine is the source, you will be referred to the right specialist in Doha with a clear summary.