Musculoskeletal diseases are the second most costly group of disorders in primary care in the Netheriands. Of the musculoskeletal disorders, hip problems occur most frequently in the aged. Therefore, in the coming decades, prevalence of hip disorders, of which an important part is attributed to osteoarthritis of the hip,' is expected to increase due to ageing of the population. The report 'Public Health Status and Forecasts 1997' predicts that by the year 2015 the incidence of osteoarthritis will have increased 36% compared to the current incidence.' Besides generating high costs, hip disorders have a major impact on the life of individuals, not only due to the presence of pain, but also because of tl,e adverse effects on the mobility and daily activities of the elderly. A recent Dutch study in the open population aged 55 years and over and living independently revealed that 16.6% of the women and 8.3% of the men reported hip pain.' In the Netherlands, the general practitioner is the fIrst physician who is consulted and therefore plays an important role in the management of these disorders. Optimal management, however, requires accurate diagnosis. The Dutch College of General Practitioners has published national gnidelines for the diagnosis, treatment and referral of many disorders in general practice.' For hip disorders, however, no such guidelines are yet available. International (ICPC) codes for several hip disorders in general practice have been introduced', but these lack clear guidelines as to what clinical criteria constitute these conditions. The possibility in the ICPC to code a hip problem as 'unspecifIed' is eagerly accepted by general practitioners; at least one tlilld of tl,e patients with hip complaints receives no specifIc diagnosis.

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Pie Medical
A. Prins (Ad) , J.A.N. Verhaar (Jan)
Erasmus University Rotterdam
Erasmus MC: University Medical Center Rotterdam

Bierma-Zeinstra, S. (1999, April 7). Hip Pain in general Practice: exploiration and classification. Retrieved from