What finding on physical exam suggests that hip osteoarthritis should be ruled out?

• A. Pain in anterior thigh
• B. Pain with internal rotation
• C. Pain in posterior thigh
• D. Pain with hip abduction

Answer: (A)

Pain in the anterior thigh is indicative of hip osteoarthritis being ruled out because it is not a typical presentation associated with this condition. In hip osteoarthritis, patients commonly experience pain in the groin or lateral hip region due to the involvement of the hip joint itself and the associated structures. If the pain is primarily located in the anterior thigh, it may suggest other issues, such as referred pain from lumbar spine pathology or may indicate a problem more related to muscle involvement rather than the hip joint itself.

The pain with internal rotation, pain in the posterior thigh, and pain with hip abduction are more closely linked to hip osteoarthritis. Internal rotation typically causes pain in individuals with hip joint degeneration due to mechanical stress within the joint. Posterior thigh pain can also originate from hip joint issues or may relate to the involvement of nearby structures such as the sacroiliac joint. Pain with hip abduction can reflect hip joint dysfunction or weakness in the surrounding musculature, which is also consistent with hip osteoarthritis. Therefore, the anterior thigh pain stands out as indicative of conditions that do not primarily involve the hip joint.