Cargando…

Causes of Chronic Hip Pain Undiagnosed or Misdiagnosed by Primary Physicians in Young Adult Patients: a Retrospective Descriptive Study

BACKGROUND: Hip pain is a common musculoskeletal complaint in general practice. Although comprehensive diagnostic approach on hip pain is mandatory for adequate treatment, un- or mis-diagnosis is not rare in primary care. The aim of this study was to analyze descriptively un- or mis-diagnosed hip pa...

Descripción completa

Detalles Bibliográficos
Autores principales: Lee, Yun Jong, Kim, Sang-Hwan, Chung, Sang Wan, Lee, Young-Kyun, Koo, Kyung-Hoi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Academy of Medical Sciences 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6300658/
https://www.ncbi.nlm.nih.gov/pubmed/30584417
http://dx.doi.org/10.3346/jkms.2018.33.e339
_version_ 1783381715208634368
author Lee, Yun Jong
Kim, Sang-Hwan
Chung, Sang Wan
Lee, Young-Kyun
Koo, Kyung-Hoi
author_facet Lee, Yun Jong
Kim, Sang-Hwan
Chung, Sang Wan
Lee, Young-Kyun
Koo, Kyung-Hoi
author_sort Lee, Yun Jong
collection PubMed
description BACKGROUND: Hip pain is a common musculoskeletal complaint in general practice. Although comprehensive diagnostic approach on hip pain is mandatory for adequate treatment, un- or mis-diagnosis is not rare in primary care. The aim of this study was to analyze descriptively un- or mis-diagnosed hip pain cases referred from primary care to a tertiary hospital, especially in young adults ≤ 50 years old. METHODS: We retrospectively analyzed a consecutive cohort of 150 patients (≤ 50 years old) with chronic hip pain (≥ 6 weeks), which was not diagnosed or misdiagnosed based on the information provided on the referral form. RESULTS: Overall an average 32 cases/month were referred due to hip pain without a diagnosis or with an incorrect diagnosis. Among them, 150 patients were enrolled in this study and 146 (97.3%) could be allocated to a specific disease by using data from routine clinical practice. Four common final diagnoses were femoroacetabular impingement (FAI) syndrome (55.3%), hip dysplasia (HD, 13.3%), referred pain from the lumbar spine (9.3%), and spondyloarthritis (SpA, 7.3%). In patients with FAI syndrome, 37 (44.0%) had pincer-type FAI and 33 (39.8%) had combined-type. Although the pain site or gender was not tightly clustered, the distribution of final diagnosis was significantly different according to hip pain location or gender. Especially, SpA or HD was not observed in younger women subgroup or elder men subgroup, respectively, when stratified by the mean age of participants. CONCLUSION: Most (> 80%) young patients with hip pain, a difficult issue to diagnosis for many primary physicians, had FAI syndrome, HD, spine lesions, and SpA. This study could give a chance to feedback information about cases with un- or mis-diagnosed hip pain, and it suggests that primary physicians need to be familiar with the diagnostic approach for these 4 diseases.
format Online
Article
Text
id pubmed-6300658
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher The Korean Academy of Medical Sciences
record_format MEDLINE/PubMed
spelling pubmed-63006582018-12-24 Causes of Chronic Hip Pain Undiagnosed or Misdiagnosed by Primary Physicians in Young Adult Patients: a Retrospective Descriptive Study Lee, Yun Jong Kim, Sang-Hwan Chung, Sang Wan Lee, Young-Kyun Koo, Kyung-Hoi J Korean Med Sci Original Article BACKGROUND: Hip pain is a common musculoskeletal complaint in general practice. Although comprehensive diagnostic approach on hip pain is mandatory for adequate treatment, un- or mis-diagnosis is not rare in primary care. The aim of this study was to analyze descriptively un- or mis-diagnosed hip pain cases referred from primary care to a tertiary hospital, especially in young adults ≤ 50 years old. METHODS: We retrospectively analyzed a consecutive cohort of 150 patients (≤ 50 years old) with chronic hip pain (≥ 6 weeks), which was not diagnosed or misdiagnosed based on the information provided on the referral form. RESULTS: Overall an average 32 cases/month were referred due to hip pain without a diagnosis or with an incorrect diagnosis. Among them, 150 patients were enrolled in this study and 146 (97.3%) could be allocated to a specific disease by using data from routine clinical practice. Four common final diagnoses were femoroacetabular impingement (FAI) syndrome (55.3%), hip dysplasia (HD, 13.3%), referred pain from the lumbar spine (9.3%), and spondyloarthritis (SpA, 7.3%). In patients with FAI syndrome, 37 (44.0%) had pincer-type FAI and 33 (39.8%) had combined-type. Although the pain site or gender was not tightly clustered, the distribution of final diagnosis was significantly different according to hip pain location or gender. Especially, SpA or HD was not observed in younger women subgroup or elder men subgroup, respectively, when stratified by the mean age of participants. CONCLUSION: Most (> 80%) young patients with hip pain, a difficult issue to diagnosis for many primary physicians, had FAI syndrome, HD, spine lesions, and SpA. This study could give a chance to feedback information about cases with un- or mis-diagnosed hip pain, and it suggests that primary physicians need to be familiar with the diagnostic approach for these 4 diseases. The Korean Academy of Medical Sciences 2018-12-11 /pmc/articles/PMC6300658/ /pubmed/30584417 http://dx.doi.org/10.3346/jkms.2018.33.e339 Text en © 2018 The Korean Academy of Medical Sciences. https://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Lee, Yun Jong
Kim, Sang-Hwan
Chung, Sang Wan
Lee, Young-Kyun
Koo, Kyung-Hoi
Causes of Chronic Hip Pain Undiagnosed or Misdiagnosed by Primary Physicians in Young Adult Patients: a Retrospective Descriptive Study
title Causes of Chronic Hip Pain Undiagnosed or Misdiagnosed by Primary Physicians in Young Adult Patients: a Retrospective Descriptive Study
title_full Causes of Chronic Hip Pain Undiagnosed or Misdiagnosed by Primary Physicians in Young Adult Patients: a Retrospective Descriptive Study
title_fullStr Causes of Chronic Hip Pain Undiagnosed or Misdiagnosed by Primary Physicians in Young Adult Patients: a Retrospective Descriptive Study
title_full_unstemmed Causes of Chronic Hip Pain Undiagnosed or Misdiagnosed by Primary Physicians in Young Adult Patients: a Retrospective Descriptive Study
title_short Causes of Chronic Hip Pain Undiagnosed or Misdiagnosed by Primary Physicians in Young Adult Patients: a Retrospective Descriptive Study
title_sort causes of chronic hip pain undiagnosed or misdiagnosed by primary physicians in young adult patients: a retrospective descriptive study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6300658/
https://www.ncbi.nlm.nih.gov/pubmed/30584417
http://dx.doi.org/10.3346/jkms.2018.33.e339
work_keys_str_mv AT leeyunjong causesofchronichippainundiagnosedormisdiagnosedbyprimaryphysiciansinyoungadultpatientsaretrospectivedescriptivestudy
AT kimsanghwan causesofchronichippainundiagnosedormisdiagnosedbyprimaryphysiciansinyoungadultpatientsaretrospectivedescriptivestudy
AT chungsangwan causesofchronichippainundiagnosedormisdiagnosedbyprimaryphysiciansinyoungadultpatientsaretrospectivedescriptivestudy
AT leeyoungkyun causesofchronichippainundiagnosedormisdiagnosedbyprimaryphysiciansinyoungadultpatientsaretrospectivedescriptivestudy
AT kookyunghoi causesofchronichippainundiagnosedormisdiagnosedbyprimaryphysiciansinyoungadultpatientsaretrospectivedescriptivestudy