This clinical mind map is organized based upon the anatomical location of the pain. Life-threatening conditions or conditions which can cause severe disability are listed in the red bold font. Probable diagnoses are divided into anterior, anterolateral, posterolateral and lateral categories or chunks. The mnemonic MAT LOST A FISH GHIPSI can help memorize these differentials.
High yield questions include the location and duration of the pain, which can help narrow down the list of differentials.
This clinical mind map is on the patient presentation of “hip pain” and not “hip joint pain,” because patients often confuse hip joint pain with other regions of the body. For example, a patient may think that they have hip joint pain, whereas the discomfort they are feeling is arising from the lower back area adjacent to the hip joint, such as SI joint, facet joint, muscles around the hip joint, trochanteric bursa, and ischial tuberosity. Several conditions present with subacute pain, while other conditions are acute or chronic. Patients sometimes describe their pain as a short duration, even when the prototype of the condition is supposed to be chronic, and vice versa. Therefore, a clinician should ask about the onset (sudden for acute and gradual for chronic pain) and take into account additional features of the history and the physical exam before arriving at the final diagnosis. SCFE and Leg-Calve-Perthe are typically present in the younger population, and therefore should be considered unlikely in the adult population.
A physical exam provides tremendous value in the evaluation process, and because historical features for various conditions overlap to a great degree, a clinician should continue to keep an open mind about the possibility of several differentials until the exam is performed. Most diagnoses are confirmed with an imaging modality, as opposed to blood tests.