The Hidden Cause of Hip Pain: When Your X-Rays Look Perfect

Why musculotendinous deficiencies are frequently underdiagnosed and how to find relief.

A painful hip following total hip arthroplasty (THA) is concerning to patients and surgeons, particularly in the setting of satisfactory postoperative radiographs. Traditionally, most painful hips are caused by periprosthetic joint infection, component loosening, and instability. However, when these major mechanical issues are ruled out, both the patient and the physician can be left searching for answers.

Other less commonly reported causes of painful THAs persist and can be related to musculotendinous deficiencies, which include iliopsoas tendinitis and abductor mechanism disruption. These frequently underdiagnosed deficiencies are poorly understood in the literature and therefore challenging to resolve.