Condition · Hip
Hip osteoarthritis
Hip osteoarthritis is the progressive degeneration of the cartilage in the hip joint. Pain severity and functional limitation matter more than the wording of a radiology report, and treatment is tailored to the stage, associated medical conditions and the patient's goals.
Clinical context
What you should know
Hip osteoarthritis may be primary or associated with dysplasia, femoroacetabular impingement, trauma, inflammatory disease or osteonecrosis. Age, weight, activity and hip anatomy affect the presentation but do not determine treatment on their own.
Pain around the hip may also arise from the lumbar spine, tendons or the trochanteric region. The diagnosis is therefore not based solely on pain location or an incidental degenerative finding on a scan.
First step
Consultation and assessment
The consultation covers the history of the pain, range of motion, gait, strength and other possible causes. Pelvic and hip radiographs taken in appropriate views are usually sufficient as the initial investigation.
MRI or CT is used selectively when radiographs do not explain the symptoms or anatomy needs clarification for planning. Modifiable risks are also discussed before possible surgery, including diabetes, smoking, active infection, dental health and anticoagulant treatment.
Stepwise treatment
Options are chosen according to the diagnosis and treatment goal
Conservative treatment
- education, activity modification and individualised exercises for movement, strength and walking
- weight loss when appropriate and temporary use of a walking stick in the opposite hand
- painkillers or anti-inflammatory medication only after assessing individual contraindications
- a selected intra-articular injection, with its role and limitations discussed beforehand; it does not replace addressing functional factors
Medication, injections and devices each have their own indications and contraindications. They are not recommended automatically and do not replace a diagnosis or monitoring of the response.
When surgery is considered
Total hip replacement may be considered when pain and functional limitation remain substantial despite appropriate non-surgical treatment, and examination and radiographs confirm relevant joint damage. The decision is not based on age or an isolated radiographic finding.
Do not delay
Signs that require prompt assessment
- sudden severe pain, inability to bear weight or deformity after a fall
- fever associated with a very painful hip or a wound
- shortening and rotation of the leg after injury — possible fracture or dislocation
In an emergency or if symptoms are severe, call 112 or go to the nearest emergency department.
Frequently asked questions
Concise answers, without blanket promises
Is hip osteoarthritis always diagnosed on MRI?
In most cases, properly taken radiographs are sufficient to assess osteoarthritis. MRI is recommended only when it can answer a specific clinical question.
When does hip replacement become an option?
When pain and loss of function significantly affect daily life, non-surgical options no longer provide acceptable control, and the likely benefits outweigh the individual's risks.
Editorial responsibility
Medically reviewed content
Dr. Răzvan Anițaș
Consultant orthopaedic and trauma surgeon; PhD in medical sciences
Last editorial update: 22 August 2026
First step
Consultation, diagnosis and a clearly explained plan
This content is educational and does not replace medical assessment. Similar symptoms can have different causes and require different treatments.