Hip Osteonecrosis Clinical Presentation

Updated: Mar 16, 2021
  • Author: Michael Levine, MD; Chief Editor: William L Jaffe, MD  more...
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Patients with osteonecrosis usually are men in the sixth decade of life who experience pain primarily in the groin but occasionally the buttocks. Pain usually is deep and throbbing and is worse with ambulation, but it also is significant at night. Onset often can be described as acute. Patients frequently describe a catching or popping sensation with motion. A history of trauma, steroid use, alcohol abuse, and other risk factors should be sought.



Physical Examination

Physical examination reveals pain with range of motion and ambulation. Limitation of internal rotation in both flexion and extension are prevalent, with passive internal rotation in extension being particularly painful. A Trendelenburg gait often is present.