We are seeing an increase in the number of patients who present with hip pain and have a greater understanding of the various etiologies that can cause this pain. It has become clear over the last decade that there is variation in the geometry and orientation of the socket (acetabulum) of the hip and also subtle changes in the contour of the head and neck of the hip joint, can lead to early onset of pain and later deterioration and arthritis. Many of these variables are genetic, in that the patient is born with some difference in orientation of the socket and contour of the head and neck. Over time, these subtle variances can lead to the presentation of osteoarthritis in the 4th or 5th decade. Some of these variables can be corrected with surgical intervention at a younger age to reorient the socket and/or recontour the junction between the ball and neck of the thigh bone. Various diagnostic studies including special projection x-rays, MRI, and CT scan can help in the diagnosis of these issues; some of which are amenable to conservative nonoperative care, others requiring surgical intervention. It is important to have these issues addressed if persistent hip pain in a younger individual is present. For more information, you can visit the American Academy of Orthopaedic Surgeons website at aaos.org.