Here I am going to try to go through hip pain in the office setting in patients over 50.  Think about location, is it in the groin, laterally or in the buttock.  Take a good history and physical exam.  Xray are beneficial but need to be WEIGHT BEARING to adequately assess for arthritis.  

Although MRI are useful for tumors, infections and osteonecrosis or fractures not seen on xray, the MRI is not as helpful in older individuals for certain diagnoses.  Most patients over 50 and almost all with arthritis have labral tears so an MRI is not necessary for those patients - wastes resources.

Lateral hip pain syndrome can include ITB syndrome, bursitis and tendinitis.  Buttock pain and radiculopathy can be from the back in individuals who have back disease.

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