Hip-spine syndrome: diagnostic challenges and treatment strategies in patients with hip osteoarthritis and degenerative lumbar spine disease

Degenerative changes in the hip and lumbar spine frequently occur together, a condition described as hip-spine syndrome.Due to the close anatomical relationship of the hip and spine, symptoms often overlap, creating diagnostic challenges in identifying the primary source of pain.We reviewed the available literature and summarized the current state of knowledge regarding the etiology, diagnosis, radiological assessment, and treatment.Overlapping symptoms may cause diagnostic difficulties, but careful history and physical examination supported by key clinical features remain critical for accurate diagnosis.In complex cases, intraarticular anesthetic injections can provide additional diagnostic value.Spinal alignment and mobility are significantly influenced by total hip arthroplasty (THA).This procedure not only improves hip function but may also enhance spinal flexibility and relieve low back pain.Although uncertainty remains regarding the optimal treatment sequence, recent studies suggest prioritizing THA before spinal surgery, as this approach reduces the risk of postoperative complications, including hip dislocation and revision surgery, and results in improved functional outcomes.It is crucial to evaluate patients with low back pain for underlying hip osteoarthritis, and those with groin or hip pain for potential lumbar spine pathology.Comprehensive clinical assessment combined with appropriate treatment selection leads to greater patient satisfaction and better overall therapeutic outcomes.