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| Differential diagnosis | Brief etiology | Key clinical presentations |
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| Hip |
| Piriformis syndrome | Compression of the sciatic nerve by piriformis muscle or hypertrophic, tender piriformis leads to neuropathic or myofascial pain, respectively | Ipsilateral radiation of buttock pain to the posterior aspect of one or both legs, exacerbated pain with prolonged sitting |
| Trochanteric bursitis | Repetitive friction due to overuse or trauma between the IT band and the greater trochanter of the femur can result in inflammation of the trochanteric bursa, located on the lateral aspect of the hip | Lateral hip pain, sleeping on the affected side, and prolonged sitting can exacerbate the pain |
| Hip fracture | Fracture is often secondary to trauma or osteoporosis | Very limited lumbar range of motion and high pain level, history, and imaging are useful in ruling out a fracture |
| Hip arthritis | The hip joint is one of the body’s largest weight-bearing joints, often impacted by osteoarthritis (OA). OA involves degeneration of the joints with age and affects articular cartilage and/or surrounding tissues of the joint | Reduced mobility and pain around the hip joint and groin are especially common, improved symptoms with movement and activity |
| Femoral acetabular impingement (hip impingement) | The femoral head of the hip pinches up against the acetabulum, leading to damage of the labrum, pain, and potentially arthritis in the long term | Discomfort while sitting or during prolonged activities |
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| Spine |
| Lumbosacral disk herniation | Involves the disruption and displacement of the annular tissue of the vertebral body in relation to the nucleus pulposus and involves four main classifications based on displacement: protrusion, extrusion, sequestration, and migration. Various inciting events such as trauma and degenerative genetic factors can lead to disc herniation | Dermatomal radicular pain dependent upon the level of herniation and sensory abnormalities such as tingling and numbness in legs and feet, and leg weakness based on impact in one or more lumbosacral nerve roots |
| Lumbosacral facet syndrome | Facet joint degeneration occurs secondary to trauma or with age and repetitive overuse. This can lead to microstructural instability and synovial facet cysts that can compress the surrounding spinal nerve roots | Pain from backward extension, radicular pain, and paraspinal muscle tenderness |
| Spondylolisthesis | This condition directly refers to the slipping of one vertebra in relation to an adjacent vertebra and can be the result of trauma, degeneration, and pathologic causes (i.e., tumor). It can lead to spondylolysis, the fracture of the pars interarticularis | Lower-limb pain is the chief symptom in adults, and radicular and back pain in children |
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| Other |
| Spondyloarthropathies | They are a group of diseases with a link to the HLA-B27 allele and several phenotypic similarities. Some examples are ankylosing spondylitis, psoriatic arthritis, and reactive arthritis | Inflammatory back pain, extra-articular features such as uveitis, psoriasis, and inflammatory bowel disease, and positive findings on laboratory tests help with diagnosis |
| Myofascial pain | Trauma or repetitive motion can perturb myofascial trigger points located in the fascia, tendons, or muscles | Paraspinal muscle weakness and radiation of pain to buttocks and thighs |
| Bone tumor | Osteosarcoma and osteoid osteoma are among several tumors in this category. A variety of molecular mechanisms tied to cancer impact the osteoblasts and osteoclasts, resulting in skeletal instability or destruction | Focal bone pain and pathologic features are often present in imaging |
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