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Health condition · Clinically reviewed

Hip arthritis, from first stiffness to a replaced joint.

Not one disease but a family - osteoarthritis, inflammatory, structural and post-traumatic. A stepped plan controls most of them, and modern surgery rescues the rest.

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A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Why trust this guide

  • 01

    Clinically reviewed

    Written by our editorial team and reviewed by a registered UK clinician before publication.

  • 02

    Sourced from guidance

    Checked against NICE, BOA, BSR and Versus Arthritis sources you can see at the end.

  • 03

    Current for 2026

    Reflects modern UK practice including robotic-assisted arthroplasty, resurfacing and biologic therapy for inflammatory disease.

Key facts

Hip arthritis at a glance.

The essentials, in plain English - what it is, the types, and how it is diagnosed and treated in the UK today.

  • What it is

    A group of conditions in which the hip joint becomes inflamed or worn - grouped together as arthritis rather than one disease.

  • Most common type

    Osteoarthritis - see our dedicated guide at /conditions/hip-osteoarthritis - accounts for the majority of cases seen in UK clinics.

  • Inflammatory forms

    Rheumatoid, psoriatic and ankylosing spondylitis - see /conditions/ankylosing-spondylitis - all behave differently to wear-and-tear disease.

  • Structural drivers

    Dysplasia, impingement, past Perthes or slipped upper femoral epiphysis - all can lead to early arthritis in adulthood.

  • Serious mimics

    Septic arthritis and avascular necrosis - two conditions that must not be missed and change management dramatically.

  • Definitive answer

    Total hip replacement - see /treatments/hip-replacement-surgery - remains one of the most effective operations in modern medicine.

Why this guide matters

One label, many diseases.

Hip arthritis covers everything from osteoarthritis to inflammatory disease and avascular necrosis. Getting the type right shapes everything that follows.

  • The right diagnosis first

    Wear-and-tear, inflammatory, structural, post-traumatic, avascular or septic - each has its own map, and X-rays and bloods together tell the story.

  • A ladder, not a leap to surgery

    Weight, physiotherapy, medication and injection buy time and function. Surgery is reserved for joints that no longer respond.

  • Modern arthroplasty is exceptional

    When it is time, hip replacement - including robotic-assisted platforms such as Mako - is one of the most transformative operations in medicine.

Types

The forms of hip arthritis.

Grouping matters - each form has its own investigations, specialists and treatment ladder.

  • Osteoarthritis

    The most common form - see /conditions/hip-osteoarthritis. Progressive cartilage wear driven by age, load and previous joint anatomy.

  • Rheumatoid arthritis

    A systemic inflammatory disease - symmetrical, often with hand and other joint involvement, managed by specialist rheumatology.

  • Seronegative spondyloarthropathy

    Ankylosing spondylitis - see /conditions/ankylosing-spondylitis - psoriatic arthritis and reactive arthritis. HLA-B27 often positive.

  • Post-traumatic arthritis

    Follows fracture, dislocation or previous hip surgery. Deterioration is often earlier and more focal than typical osteoarthritis.

  • Avascular necrosis

    Loss of blood supply to the femoral head - linked to alcohol, steroids and sickle cell disease. Needs urgent MRI and specialist commissioned care.

  • Hip dysplasia

    See /conditions/hip-dysplasia - shallow acetabular coverage that overloads the joint and drives early arthritis in young adults.

  • FAI-associated arthritis

    See /conditions/hip-impingement - femoroacetabular impingement causes labral damage and cartilage loss over time.

  • SUFE and Perthes legacies

    Adults who had slipped upper femoral epiphysis or Perthes - see /conditions/legg-calve-perthes-disease - carry a higher risk of early hip arthritis.

  • Septic arthritis

    A joint infection - fever, severe pain and an unable-to-weight-bear picture. A surgical emergency needing urgent aspiration and antibiotics.

  • Crystal arthropathy

    Gout - see /conditions/gout - and CPPD - see /conditions/calcium-crystal-diseases - can affect the hip and are confirmed by aspiration.

  • Inflammatory arthritis - other

    Juvenile idiopathic arthritis and SLE can involve the hip. Diagnosis and treatment are specialist rheumatology-led.

  • Mixed and overlapping

    Real patients often carry more than one - a dysplastic hip that develops osteoarthritis, or an inflammatory joint with superimposed post-traumatic change.

How the diagnosis is made

From first groin pain to a clear plan.

The steps a UK GP, orthopaedic surgeon or rheumatologist will normally follow, in order - so you know what to expect and why.

  1. 01

    Assessing

    History and pattern of pain

    Groin, buttock or thigh pain, morning stiffness, limp and functional impairment - the pattern often points to the type.

  2. 02

    Assessing

    Focused examination

    Range of motion, gait, leg length and provocation tests - together with red-flag screening for infection and vascular disease.

  3. 03

    Assessing

    Weight-bearing X-rays

    The first-line image - joint space narrowing, osteophytes, subchondral change and clues to dysplasia or impingement.

  4. 04

    Confirming

    MRI when needed

    See /treatments/private-mri-scan - reserved for suspected avascular necrosis, labral pathology or normal X-rays with disabling pain.

  5. 05

    Confirming

    Rheumatology bloods

    RF, anti-CCP, ANA, HLA-B27 and inflammatory markers - to identify rheumatoid, psoriatic or seronegative spondyloarthropathy.

  6. 06

    Confirming

    Joint aspiration if indicated

    Reserved for suspected septic or crystal arthritis - urgent under specialist care, never a routine step.

  7. 07

    Planning

    MDT specialist plan

    Orthopaedics, rheumatology and musculoskeletal physio agree the ladder from lifestyle to arthroplasty.

Typical timeline: a first visit to a settled plan in weeks, not months.

Symptoms

What hip arthritis actually feels like.

Groin pain, a stiff joint and a limp - and the features that mean it is time to escalate to a specialist.

  • Groin pain

    The classic distribution - a deep ache in the groin that catches with weight-bearing and end-range movement.

  • Buttock and thigh pain

    Radiating discomfort into the buttock or front of the thigh - sometimes confused with back or knee pathology.

  • Reduced range of motion

    Internal rotation is usually the first to go - putting on socks, tying shoelaces and getting in and out of a car all become harder.

  • Morning stiffness

    Common in both wear-and-tear and inflammatory disease - prolonged, gel-like stiffness points more to inflammatory forms.

  • Limp and antalgic gait

    Shorter time spent on the painful side while walking - often the first thing family and friends notice.

  • Night pain

    Pain that disturbs sleep or waking with hip pain - a marker of more advanced disease and a lower threshold to escalate.

  • Functional impairment

    Stairs, socks, walking distance and getting off a low chair - the everyday tasks that show a joint is failing.

  • Red flag - fever or acute severe pain

    Fever, systemic illness or the sudden inability to weight-bear may signal septic arthritis - urgent assessment is needed.

Treatment

How hip arthritis is treated in the UK.

A stepped ladder - lifestyle, physiotherapy, medication, injection, disease-modifying therapy where relevant, and surgery when the joint no longer responds.

  • Weight and activity modification

    Small reductions in load - weight, high-impact sport, unnecessary stairs - can meaningfully reduce symptoms and slow progression.

  • Specialist musculoskeletal physio

    Structured strengthening of the glutes, hip abductors and core - the single most under-used treatment for hip arthritis.

  • Simple analgesia and NSAIDs

    Paracetamol and short-course NSAIDs where appropriate - topical NSAIDs for those who tolerate oral treatment poorly.

  • Intra-articular steroid injection

    See /treatments/steroid-injection - a specialist musculoskeletal option for short-term relief. Risks are weighed carefully before arthroplasty.

  • DMARDs and biologics

    For rheumatoid, psoriatic and seronegative disease - specialist rheumatology-led therapy that changes the natural history of the disease.

  • Hip resurfacing

    See /conditions/hip-resurfacing - a bone-conserving option for younger, active patients, delivered in specialist commissioned centres.

  • Total hip replacement

    See /treatments/hip-replacement-surgery - the definitive option, increasingly delivered with robotic-assisted platforms such as Mako in specialist centres.

  • MDT specialist care

    Orthopaedics, rheumatology, physio and organisations like Versus Arthritis - together they hold the plan across the life of the joint.

What this guide is based on

The sources behind every claim on this page.

UK national guidance and specialist society standards, current at the time of last review.

Key references

Guidelines and standards we relied on.

A quiet reminder

This guide is for information, not medical advice.

Your GP, orthopaedic surgeon or rheumatologist knows your hip and your history and can tell you which parts apply to you. If in doubt, get seen.

  • NICE. Osteoarthritis in over 16s: diagnosis and management (NG226).

  • British Orthopaedic Association (BOA). Standards for the care of the arthritic hip.

  • British Society for Rheumatology (BSR). Guidelines for rheumatoid, psoriatic and axial spondyloarthritis.

  • Versus Arthritis. Patient information on hip arthritis and hip replacement.

Red flags

When hip pain needs urgent attention.

Most hip arthritis is managed in outpatient clinics. These are the situations that need a faster, specialist response.

  • Septic arthritis

    Fever, severe pain and inability to weight-bear - a surgical emergency needing urgent aspiration, IV antibiotics and specialist orthopaedic care.

  • Avascular necrosis

    Severe pain out of proportion to X-ray findings - classically linked to alcohol, steroid use or sickle cell disease. Needs urgent MRI and specialist commissioned care.

  • Rapidly destructive arthropathy

    Fast joint-space loss over weeks to months - warrants prompt orthopaedic review and a low threshold for surgery.

  • Systemic inflammatory disease

    Multiple joints, prolonged morning stiffness, rashes or eye symptoms - suggests rheumatoid or spondyloarthropathy and needs specialist rheumatology.

  • Referred pain

    Groin pain can come from the spine, pelvis or abdomen - back pain, hernia or intra-abdominal disease should always be considered.

  • Metastatic bone disease

    Night pain, weight loss or a personal history of cancer with new hip pain warrants urgent imaging.

  • Post-traumatic deterioration

    Previous fracture, dislocation or hip surgery followed by worsening pain - post-traumatic arthritis needs specialist orthopaedic review.

  • Paediatric legacies

    Adults with a history of dysplasia, Perthes - see /conditions/legg-calve-perthes-disease - or slipped upper femoral epiphysis are at risk of early arthritis.

  • Crystal disease

    Gout - see /conditions/gout - and CPPD - see /conditions/calcium-crystal-diseases - can affect the hip and need aspiration to confirm.

Living with it

A treatable condition, with a clear ladder.

Four things that make the biggest difference day to day - keep moving, invest in strength, protect the joint with sensible load, and know when to step up.

A quiet reminder

Consistency beats intensity, every time.

Small, steady habits - kept up for months - do more than a heroic week that does not last.

  1. 01 Move

    Keep moving, mindfully

    Regular low-impact activity - walking, cycling, swimming - preserves function and reduces pain more than rest ever does.

  2. 02 Strength

    Invest in your glutes

    Specialist musculoskeletal physio and hip-focused strengthening are the most under-used treatments for hip arthritis.

  3. 03 Weight

    Small changes, big returns

    Even a modest loss of body weight meaningfully reduces load through the joint and improves both pain and surgical outcomes.

  4. 04 Escalate

    Do not tolerate a failing joint

    When pain limits sleep, work or walking distance, ask about hip replacement - it is one of the most effective operations in medicine.

Frequently asked

Everything we get asked about hip arthritis.

Quick answers on diagnosis, treatment, hip resurfacing, hip replacement and avascular necrosis.

  • What is hip arthritis?

    A group of conditions in which the hip joint becomes inflamed, damaged or worn. The most common form is osteoarthritis, but rheumatoid, psoriatic, ankylosing spondylitis, post-traumatic, avascular necrosis and crystal-related disease can all affect the hip.

  • How is hip arthritis diagnosed?

    With a careful history, focused examination and weight-bearing X-rays as the first-line investigation. MRI is reserved for suspected avascular necrosis, labral pathology or disabling pain with normal X-rays, and blood tests are used when an inflammatory cause is suspected.

  • What are the treatment options for hip arthritis?

    Treatment follows a ladder - weight and activity modification, specialist musculoskeletal physiotherapy, simple analgesia and NSAIDs, intra-articular steroid injection where appropriate, DMARDs or biologics for inflammatory disease, and hip resurfacing or total hip replacement for advanced disease.

  • When should I consider hip replacement?

    When pain, stiffness and functional impairment are no longer controlled by lifestyle, physiotherapy, medication and injections - and when they are affecting sleep, work or independence. Modern arthroplasty, including robotic-assisted platforms such as Mako, delivers excellent long-term outcomes for the right patient.

  • Is hip resurfacing an option for me?

    Hip resurfacing - see /conditions/hip-resurfacing - is a bone-conserving alternative to total hip replacement, delivered in specialist commissioned centres. It suits a selected group of younger, active patients with good bone stock and is discussed as part of a specialist orthopaedic conversation.

  • What is avascular necrosis of the hip?

    Loss of blood supply to the femoral head that leads to bone death and, ultimately, collapse of the joint surface. It is linked to alcohol excess, corticosteroid use and sickle cell disease, and needs urgent MRI and specialist commissioned care to preserve the joint where possible.

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