変形性股関節症における股関節痛の検討：疼痛領域の多様性

Patterns of Pain Referral of Patients with Pain due to Osteoarthritis of the Hip

　初回人工股関節置換術を行った変形性股関節症138股(男：女＝24：114，平均年齢62歳)を対象に股関節由来の疼痛領域を調査した．疼痛領域は鼡径部67％，股関節側方61％，殿部54％と股関節周囲で99％を占め，大腿部(大腿近位1/3から膝蓋骨高位)16％，下腿部7％であった(複数回答を含む)．鼡径部痛を訴えない症例は33％に及び，また，変形性股関節症の固有疼痛領域を同定できず，本症の病態の多様性を反映していた．下腿部の疼痛は7％に認められ，腰椎疾患との鑑別の重要性が示唆された．

　The features of pain in patients with ostearthritis of the hip (HOA) have never been well documented in detail.　The present study was designed to assess the patterns of pain referral in patients presenting with pain associated with HOA.　Among the 138 patients with pain due to HOA treated by primary total hip arthroplasty the location of the pain was the groin in 92 patients (67%), the greater trochanter in 84 (61%), the buttocks in 75 (54%), the anterior and lateral thigh in 22 (16%), and the leg in 9 (7%).　The pain associated with HOA tends to occur in three major areas around the hip：the groin, the greater trochanter, and the buttocks.　However, we could not identify particular areas of pain associated with HOA.　The fact that pain occasionally also occurs in the leg confirms the potential difficulty of assessing patients who present with both hip pain and back pain.