Bio-mechanical Dysfunction of a Pre-arthritic Hip (Clinical Perspective – Review)

(Synopsis) Clinical Presentation, Altered Biomechanics, Diagnostic Plain Film Study Indications, Diagnostic Advanced Imaging Modality of Choice, T2 Mapping MRI Indications, dGMRIC Indications, MR-A Indications, Bone CT 3-D Indications, Complementary Diagnostic Procedures, Clinical Considerations, Differential Diagnosis, Evidence Based Treatment Protocol (Revised: August 2022)

[Commission on Chiropractic Clinical Practice Guidelines (CCCPG); 2022 August 26]

Presentation History: (The 3rd Iranian Chiropractic Association Multidisciplinary Symposium on Functional Disorders of the Extremities and Related Neurology – Main Conference Hall, University of Tabarsi, Tehran, Iran; January 25, 2019)



The hip articulation plays an important role in the normal bio-mechanic of the pelvis, and at times it is in-fact the main etiology. However, in the absence of clear pathology, its contribution is often ignored by the clinician and not considered in the differential diagnosis. Furthermore, some of the symptoms attributed to upper lumbar discopathy, as well as the sacro-iliac articulation can be mimicked by the dysfunctional pre-arthritic hip.


To provide an overview of different clinical and diagnostic modalities for early accurate  diagnosis of bio-mechanical dysfunctions of a pre-arthritic hip and its related symptomatology.


Considering the relatively high frequency of gluteal pain extending to the hip region, associated with mid to upper lumbar radiculitis and low back pain, the hip articulation should always be included in the differential diagnosis. It is important to note that majority of pre-arthritic hip bio-mechanical dysfunction, which may either contribute and or be the main cause of the chief complaint, can be misdiagnosed in clinical evaluation as well as routine imaging studies. It is therefore, essential to have a clear understanding of the clinical presentation and diagnostic imaging modalities available for the hip and their specific indications.

H. Sabbagh DC, CCCN

Scientific Director: H. Sabbagh DC

Pre-Recorded Presentation:

Published: January 12, 2019

Revised: August 26, 2022

©2022H. Sabbagh D.C. (All Rights Reserved)