BACKGROUND: Hip osteoarthritis has been considered a condition commonly encountered in the elderly, however, it is predicted to be increasing in prevalence in the population below age 50. Avascular necrosis (AVN) is usually caused by a compromise in blood flow, usually occurring in patients with risk factors.

CASE REPORT: A 37-year-old man presented with left-sided hip pain. Magnetic resonance imaging revealed severe left hip osteoarthritis, as well as bilateral hip AVN, although the patient had no known risk factors.

CONCLUSIONS: Historically, differential diagnoses for hip pain in younger patients have not typically included osteoarthritis. However, hip osteoarthritis can occur in younger patients, and coexisting AVN can occur without known risk factors. It is crucial to consider these as differential diagnoses in young patients with hip pain. Future studies are needed to evaluate the prevalence of early hip osteoarthritis with coexisting AVN in patients younger than 50 years.

KEYWORDS: Osteoarthritis, avascular necrosis, back pain, case report, hip pain