A Pattern Taught Specifically to Avoid Missing It
Hip joint pathology — including osteoarthritis, labral tears and, particularly in children, slipped capital femoral epiphysis — can present with pain felt predominantly or even exclusively at the knee, with little or no pain reported at the hip itself, making this one of the more well-recognised traps in musculoskeletal assessment.
A Shared Nerve Supply
This referral pattern is explained by the shared innervation of the hip and knee joints via the obturator and femoral nerves, which carry sensory information from both regions — the nervous system can struggle to precisely localise the true source when deep joint structures are involved (Margo et al., 2003).
Why the Hip Is Always on the Checklist
Because of how well established and clinically significant this pattern is, a competent knee assessment routinely screens hip range of motion and provocative hip tests, particularly when knee imaging and local examination fail to adequately explain the presenting pain.
References & Further Reading
- Margo K, Drezner J, Motzkin D. Evaluation and management of hip pain: an algorithmic approach. J Fam Pract. 2003;52(8):607-617.