Where it hurts is the most useful clue you have. Groin pain, outer hip pain and buttock pain come from different structures and need different management — and one of the most commonly mistaken is greater trochanteric pain syndrome, which is frequently treated as hip joint disease when it is a tendon problem. Ultrasound assesses the soft tissues around the hip in real time and can settle which of the three you are dealing with.
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Hip and groin pain is a common presentation with a wide differential diagnosis. The location of the pain — anterior (groin), lateral (outer hip), or posterior (buttock) — is the most important clue to the underlying cause.
| Location | Common causes |
|---|---|
| Anterior (groin) | Hip joint pathology (osteoarthritis, labral tear), iliopsoas tendinopathy or bursitis, adductor tendinopathy, inguinal hernia, sports hernia |
| Lateral (outer hip) | Greater trochanteric pain syndrome (gluteal tendinopathy and trochanteric bursitis), iliotibial band syndrome |
| Posterior (buttock) | Piriformis syndrome, hamstring tendinopathy, referred pain from the lumbar spine |
A hip ultrasound scan is appropriate when:
A hip ultrasound assesses:
The dynamic element matters here more than in most regions. A snapping hip and a hernia both reveal themselves on movement, and neither is reliably captured by static imaging.
Being clear about this saves wasted appointments. Ultrasound images soft tissue well and bone poorly. It cannot assess:
If your pain is deep in the groin, worse on weight-bearing and associated with stiffness and restricted rotation, the hip joint itself is the likely source and an X-ray is usually the better starting point. Our guide to MSK ultrasound sets out how the modalities compare.
See a doctor urgently rather than booking a scan if you have: hip or groin pain after a fall, especially if you cannot weight-bear; a hot, swollen, painful hip with fever; pain with unexplained weight loss or night sweats; new numbness, weakness or loss of bladder or bowel control; or a history of cancer with new hip pain. These need medical assessment, not an outpatient ultrasound.
Greater trochanteric pain syndrome (GTPS) — pain on the outer aspect of the hip — is frequently misdiagnosed as hip joint pathology or referred lumbar spine pain. The ultrasound appearance is characteristic: thickening and hypoechogenicity of the gluteal tendons at their greater trochanteric insertion, often with associated bursal fluid.
Identifying GTPS on ultrasound changes the management pathway. The patient needs targeted physiotherapy and, in some cases, an ultrasound-guided injection — not hip replacement surgery.
Describes general patterns across the patients we scan, not any individual case.
No. Warmed gel is applied and a probe is moved over the skin. You may be asked to move the hip or to strain, which can reproduce your symptoms briefly, but the scan itself is painless.
No. The labrum lies deep within the joint and is not reliably assessed by ultrasound. MR arthrography is the appropriate investigation. Ultrasound is used for the soft tissues around the joint — tendons, bursae and hernias.
Pain over the bony point on the outer hip, caused by gluteal tendinopathy with or without bursitis. It is often mistaken for arthritis of the hip joint, but it is a tendon problem and responds to targeted loading exercises rather than joint surgery.
Yes. Ultrasound can identify inguinal and femoral hernias and assess whether they reduce, and it can be performed while you stand and strain, which frequently reveals a hernia not visible lying down.
No. You can book a hip ultrasound directly with us, and we can send the report to your GP or physiotherapist at your request.
A hip ultrasound is £235. You receive instant verbal results at the appointment from the consultant performing your scan, with the written report following within 24 hours.
Related: ultrasound-guided injections, knee pain, and the full range of MSK ultrasound scans.
CQC-registered clinic · HCPC-registered sonographers · BMUS member · ICO-registered. Reports can be shared securely with your NHS GP or specialist at your request.
More on hernias: hernia ultrasound questions answered.
