Hip Pain Uncovered: How Ultrasound Helps Diagnose Common Causes

🕒 Read Time: 6–7 minutes

(Because guessing shouldn’t be part of your recovery plan)

If you've ever winced while walking up the stairs, struggled to put on socks, or felt a deep ache around your hip after sitting too long—you’re not alone. Hip pain is incredibly common, but also incredibly misunderstood.

Why? Because there are a lot of moving parts (literally) in and around the hip. Muscles, tendons, bursae, ligaments, joints, nerves—they all hang out in the same neighbourhood. And when one gets irritated or injured, it’s not always clear which one is causing the problem.

That’s where musculoskeletal ultrasound steps in. Fast, safe, and surprisingly detailed, it’s one of the most effective ways to uncover what’s really going on inside your hip—so you can stop guessing and start getting better.

Let’s take a look at what ultrasound can detect, why it’s a great first-line scan for hip pain, and how it might be the missing link in your recovery journey.

First: Why Is Hip Pain So Tricky?

Because your hip joint is surrounded by layers of soft tissue, and pain can come from any of them. Add in the fact that hip pain is often felt somewhere else—like the groin, buttock, thigh, or even down the leg—and it’s easy to misdiagnose.

You might be dealing with:
• Tendon overload or tearing
• Inflammation of bursae (fluid-filled sacs)
• Referred pain from the spine
• Nerve entrapments
• Early-stage arthritis
• Or even something simple like tight hip flexors

But how do you figure that out without a clear image?

What Is Musculoskeletal Ultrasound?

SpMusculoskeletal (MSK) ultrasound uses high-frequency sound waves to create live images of the soft tissues around your joints - things like tendons, ligaments, muscles, bursae, and nerves.

It’s:
✅ Safe (no radiation)
✅ Fast (scans take 15–20 minutes)
✅ Dynamic (we can watch things move in real time)
✅ Incredibly useful for pinpointing the source of soft tissue pain

And yes—it’s just as effective for the hip as it is for shoulders, knees, and ankles.

What Hip Conditions Can Ultrasound Diagnose?

🔥 1. Gluteal Tendinopathy (or Tendon Tears)
‍Pain on the side of your hip, especially when lying on it, walking uphill, or getting up from a chair? That could be your gluteus medius or minimus tendons acting up.

These tendons help stabilise your hip during movement, and over time (or after injury), they can become irritated, weakened, or even torn.
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🎯 What ultrasound shows:
• Tendon thickening, degeneration, or tears
• Inflammation around the tendon
• Any associated bursitis or swelling

This is one of the most common causes of hip pain in women over 40—and is often misdiagnosed as “hip arthritis.”

💧 2. Trochanteric Bursitis
‍Right next door to your gluteal tendons lives the trochanteric bursa - a small, fluid-filled sac that helps reduce friction between tendons and bone.

If it gets irritated? It swells up, becomes painful, and you’ve got yourself a case of bursitis.

🎯 What ultrasound shows:
• Bursa enlargement
• Fluid or inflammation
• Whether it’s bursitis on its own or part of a bigger tendon problem

Ultrasound can also help guide injections if needed, making them more accurate and effective.

🚶 3. Hip Flexor or Iliopsoas Issues
‍Pain in the front of the hip or groin, especially when lifting your leg, might be linked to your hip flexors, including the powerful iliopsoas muscle and tendon.

Overuse, tightness, or even small tears can cause sharp or deep aching pain, especially in runners, dancers, or people who sit a lot.

🎯 What ultrasound shows:
• Muscle or tendon strain
• Inflammation or fluid in the iliopsoas bursa
• Dynamic movement—seeing how the tendon behaves during hip flexion

🦵 4. Hamstring or Adductor Injuries
‍If you’ve had a sports injury or sudden pain in the back or inner thigh, it could be a strain or tear of the hamstring or adductor tendons where they attach near the hip

.🎯 What ultrasound shows:
• Partial or full-thickness tendon tears
• Muscle fibre disruption
• Bleeding, swelling, or haematoma
• Healing progress over time

Perfect for athletes or gym-goers dealing with persistent groin pain.

⚡ 5. Nerve Entrapments
‍Sometimes hip or groin pain isn’t muscular—it’s neurological. Conditions like meralgia paresthetica (compression of the lateral femoral cutaneous nerve) can cause burning, tingling, or numbness along the outer thigh.

🎯 What ultrasound shows:
• Nerve swelling or entrapment
• Compression from surrounding tissues
• Whether the nerve is gliding properly during movement

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How Does the Scan Work?

Super simple. Here’s what to expect:
1. You lie comfortably while your clinician chats with you about your symptoms.
2. A bit of cold gel is applied to the skin around your hip.
3. A handheld scanner (called a transducer) glides over the area.
4. The images appear instantly on screen, and you might even see your muscles or tendons move as you do!

The scan takes about 15–20 minutes, and the results are often explained right there and then.

What Happens After the Scan?

Once we’ve identified the issue, treatment can begin—immediately. Depending on your diagnosis, this might include:
Tailored physiotherapy or rehab
Shockwave therapy for chronic tendon issues
‍Dry needling or manual therapy
‍Ultrasound-guided injections (for bursitis or inflammation)
Referral for further imaging or orthopaedic opinion (if needed)

🎯 No more trial-and-error. Just a clear plan, based on real information.

Final Thoughts: Your Hip Deserves Clarity

Hip pain can be frustrating, confusing, and stubborn—but it doesn’t have to be a mystery.

With musculoskeletal ultrasound, we can take the guesswork out of diagnosis and get to the root of the problem quickly and accurately.

Whether you’ve been limping for weeks, wincing through workouts, or just feeling off around your hip—a simple ultrasound scan might be the first step to getting your movement (and your comfort) back.

Tired of wondering what’s causing your hip pain?
Let’s find out. Book your MSK ultrasound today and take the first step toward clarity, comfort, and confident movement.