Most PTs Misdiagnose Hip Osteoarthritis… Here’s How to Get It Right

By dpope2020

April 17, 2026

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Most PTs Misdiagnose Hip Osteoarthritis… Here’s How to Get It Right

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In today's video we go over, Most PTs Misdiagnose Hip Osteoarthritis… Here’s How to Get It Right

Are you confident you're diagnosing hip osteoarthritis correctly — or are you accidentally missing it, or worse, misattributing it to FAI, gluteal tendinopathy, or lumbar pathology?

Hip OA is one of the most commonly misdiagnosed conditions in the clinic. With overlapping presentations and no single definitive test, even experienced PTs can get it wrong — leading to ineffective treatment plans, frustrated patients, and stalled outcomes. In this video, we'll walks you through a systematic, evidence-based approach to accurately diagnosing hip osteoarthritis — so you can stop guessing and start treating with confidence.

You'll learn:

✅ Which patient populations are highest risk for hip OA (and why it matters for your clinical reasoning)

✅ The hallmark clinical presentation signs you should be looking for at intake

✅ Gait deviations that reveal hip OA before you even run a single test

✅ The key ROM threshold that significantly raises diagnostic likelihood

✅ Evidence-based special tests drawn directly from JAMA research

✅ How to confidently differentiate hip OA from FAI, gluteal tendinopathy, lumbar pathology, and inflammatory arthropathies

👍 Like this video if it helped sharpen your clinical reasoning.

TIMELINE:

  • 00:00 – Why Accurate Hip OA Diagnosis Is Critical
  • 00:22 – Who Gets Hip OA? Risk Factors & Demographics
  • 01:11 – Clinical Presentation of Hip Osteoarthritis
  • 01:40 – Gait Deviations & Movement Compensations
  • 02:48 – Key Diagnostic Sign: Hip Internal Rotation ROM
  • 03:19 – Evidence-Based Special Tests (JAMA)
  • 04:03 – Differential Diagnosis Overview
  • 04:07 – FAI vs. Hip OA: How to Tell Them Apart
  • 04:51 – Ruling Out Gluteal Tendinopathy
  • 05:13 – Ruling Out Lumbar Spine Pathology
  • 06:02 – Inflammatory Arthropathies (RA & Psoriatic Arthritis)
  • 06:20 – Next Steps: FAI Diagnosis Video

I think we have some arthritis!

- Dan Pope DPT,OCS,CSCS

Show Notes / Relevant Articles:

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Thank you!

Dan Pope DPT, OCS, CSCS

References: 

  1. Koc TA Jr, Cibulka M, Enseki KR, Gentile JT, MacDonald CW, Kollmorgen RC, Martin RL. Hip Pain and Mobility Deficits-Hip Osteoarthritis: Revision 2025. J Orthop Sports Phys Ther. 2025 Nov;55(11):CPG1-CPG31. doi: 10.2519/jospt.2025.0301. PMID: 41165671.
  2. Metcalfe D, Perry DC, Claireaux HA, Simel DL, Zogg CK, Costa ML. Does This Patient Have Hip Osteoarthritis? The Rational Clinical Examination Systematic Review. JAMA. 2019;322(23):2323–2333. doi:10.1001/jama.2019.19413
  3. Katz JN, Arant KR, Loeser RF. Diagnosis and Treatment of Hip and Knee Osteoarthritis: A Review. JAMA. 2021 Feb 9;325(6):568-578. doi: 10.1001/jama.2020.22171. PMID: 33560326; PMCID: PMC8225295.