Hip Pain: Could It Be Avascular Necrosis? - Orthopedics

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Hip pain can be a complex issue, and your symptoms suggest that there could be several underlying causes. Avascular necrosis (AVN), also known as osteonecrosis, is one potential cause of hip pain, particularly if it is associated with the groin and inner thigh. AVN occurs when blood flow to the bone is disrupted, leading to bone death and subsequent joint pain. This condition is often linked to risk factors such as long-term steroid use, excessive alcohol consumption, or trauma, none of which you report having experienced. However, it can also occur without any identifiable risk factors.

Your description of pain in the groin and inner thigh, especially during movement or after prolonged activity, is consistent with symptoms of AVN. The pain may be exacerbated by weight-bearing activities, and you might also experience a limited range of motion in the hip joint. The fact that you have had a previous injury (anterior cruciate ligament tear) and have been doing rehabilitation exercises could potentially contribute to muscle strain or inflammation, which might mimic or exacerbate hip pain.

It’s also important to consider other potential causes of your symptoms. For instance, hip impingement, bursitis, or tendinitis could lead to similar pain patterns. Inflammation of the hip joint or surrounding soft tissues can result from overuse or strain, particularly if you have been engaging in activities that put stress on the hip joint, such as the rehabilitation exercises you mentioned.
Your report of lower back pain could also be related. The hip and lower back are interconnected, and issues in one area can often lead to discomfort in the other. For example, if your hip joint is not functioning optimally, it can lead to compensatory movements that strain the lower back.

Given that your initial evaluation by a general practitioner suggested groin inflammation, it may be worthwhile to pursue further diagnostic imaging, such as an MRI, which can provide a clearer picture of the hip joint and help rule out AVN or other conditions. X-rays may not always show early changes associated with AVN, so an MRI is often more sensitive in detecting early bone changes.

In the meantime, consider the following recommendations:
1. Activity Modification: Avoid activities that exacerbate your pain. If certain movements or exercises are causing discomfort, it may be beneficial to modify or temporarily halt those activities.

2. Physical Therapy: Engaging in physical therapy can help strengthen the muscles around the hip and improve flexibility, which may alleviate some of the pain. A physical therapist can also provide guidance on proper exercise techniques to avoid further injury.

3. Pain Management: Over-the-counter anti-inflammatory medications may help reduce pain and inflammation. However, consult with a healthcare provider before starting any new medication.

4. Follow-Up: Since your symptoms are persisting, it would be prudent to follow up with an orthopedic specialist or a sports medicine physician who can provide a more detailed assessment and potentially recommend imaging studies.

5. Lifestyle Factors: Although you mentioned not smoking or drinking, maintaining a healthy lifestyle with a balanced diet and regular, low-impact exercise can support overall joint health.

In summary, while avascular necrosis is a possibility, there are several other conditions that could be contributing to your hip pain. A thorough evaluation by a specialist, along with appropriate imaging, will be crucial in determining the exact cause and guiding effective treatment.