Hip Arthritis presenting as Sciatica

1
Hip Arthritis presenting as Sciatica

• Manoj Krishna

2
62.M. Urgent referral. Severe sciatica.

• GP referred this 62 year old man with bilateral
  leg pain from hips downwards and some low back
  pain
• Patient was unable to walk more than 10 yards
• Slow onset of pain
• Walked with a slow waddling gait
• SLR 20 degrees caused leg pain
• No neurodeficit
• Mild spinal tenderness.

3
Hip Arthritis

• Difficulty walking
• Pain in buttocks and thigh- going down the leg.
• Pain increased on walking and eased on sitting
• Limited SLR
• Back Pain occurs because the locked hips cause
  the back and pelvis to twist with each step
• Hip replacements sorted his back and leg pain out.

4
Key Lessons

• Always check the hips in every patient presenting
  with back and leg pain
• Hip arthritis can mimic sciatica in its
  presentation
• If they have back and hip pain- always operate on
  the hip first- it usually also cures the back pain