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Hip Arthritis presenting as Sciatica

Hip Arthritis presenting as Sciatica. Manoj Krishna. 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

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Hip Arthritis presenting as Sciatica

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  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

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