Patient case study
Modassir’s story: why his hip and lower back both hurtWhat a standing EOS scan showed about his hip, pelvis and legs
- Lower back
- Hip
- Hip wear
- Pelvic imbalance
- Leg length difference
Most scans look where it hurts. This scan shows you why it hurts.
Modassir’s own scan video, shared with his permission.
The short answer
Why did Modassir’s hip and lower back both hurt?
Why did Modassir’s hip and lower back both hurt? His hip was worn, but that was only part of it. His standing EOS scan showed the hip wear sat alongside a pelvis that was out of balance and a difference in leg length, all linked. Together, they help explain why both his hip and his lower back were under strain. His care moved from a hip-only diagnosis to a whole-body plan.
- Patient
- Modassir
- How he came to us
- Referred for a standing scan
- What hurt
- Severe lower back and hip pain
- Diagnosis before the scan
- Focused on the hip
- Scan
- EOS full-body standing scan, front and side views
- Key findings
- Hip wear, pelvic imbalance, leg length difference
- Plan after the scan
- A whole-body, alignment-focused approach
- Where
- ScanAlign, 19 Harley Street, London
Before the scan
The hip diagnosis was right, but it was not the whole story
Modassir came to us with severe lower back and hip pain. He was referred for a standing scan with a diagnosis that focused on his hip.
That diagnosis was not wrong. His hip did show wear. But a single-joint diagnosis explains the joint, not always the pattern around it. It did not fully explain why his lower back hurt as well.
So the question was not only what was wrong with the hip. It was why the hip and the lower back were both under strain.
The worn hip was real. It was also one link in a longer chain.
What the scan found
Three findings, one picture
His scan showed a broader mechanical problem linking hip wear, pelvic imbalance and a leg length difference. Here is what each one means, and why it mattered.
Hip wear
The hip joint showed signs of wear. This was real, and it stays part of the picture.
What it isOver time, the smooth surfaces inside the hip joint can wear. This is often called degeneration or osteoarthritis, and it can cause pain in the hip, groin or buttock.
Why it mattered for ModassirHis diagnosis had focused on the hip. The wear explained some of his pain, but not why his lower back hurt too.
What the standing scan showsA standing image shows the hip while it carries body weight, alongside the pelvis and legs that decide how that weight arrives.
Pelvic imbalance
The two sides of his pelvis did not sit evenly, which is sometimes described as uneven hips.
What it isThe pelvis is the base of your spine and the top of your legs. When one side sits higher, everything above and below it has to adjust.
Why it mattered for ModassirAn uneven pelvis changes how load reaches both hips and the lower back, the two areas where Modassir felt pain.
What the standing scan showsBoth sides of the pelvis are captured in one standing image, so their levels can be compared directly.
Leg length difference
His legs were not the same length.
What it isA leg length difference can come from the bones themselves, or from the way the pelvis sits, which makes one leg act shorter.
Why it mattered for ModassirA difference repeats with every step you take, so its effect builds up over time. It can set the pelvis off level each time you stand and walk.
What the standing scan showsBoth legs are imaged from hip to heel while standing, unstitched and non-magnified, so their lengths can be compared on the same image at true size.
How it connects
From his legs to his lower back, step by step
Select each step to see where it sits in the body.
Modassir’s legs were not the same length. That means one side of his body sat slightly lower every time he stood or walked.
The pelvis rests on top of the legs, so it tips towards the shorter side. This is sometimes called a lateral pelvic tilt.
With the pelvis off level, weight passes through the hip joints at an angle. His hip already showed wear, and uneven load is harder on a joint that is already worn.
The spine sits on the pelvis, so the lower back has to adjust to keep him upright. That extra work is one reason lower back pain so often travels with a hip and pelvis problem.
Watch the scan
Watching Modassir’s scan: what to look for
The video walks through his real EOS images, front and side. You do not need any medical training to follow it. These three things are worth watching for.
What to look for in the video
- Check whether the two sides of the pelvis sit at the same height.
- Compare the length of the two legs, from hip to heel.
- Look at the hip joint itself, where the wear shows.
What a standing EOS scan shows
- How your bones and joints line up when you stand
- Whether the two sides of your pelvis sit level
- Leg length from hip to heel, at true size, as in a full-leg standing X-ray
- The shape of your joints and the space inside them while they carry weight
- The curves of your whole spine, front and side
What it does not show
- Cartilage, muscles, tendons and ligaments in detail
- Discs and nerves in detail
- Inflammation and other soft-tissue causes of pain
For these, MRI is usually the better tool. Sometimes the two scans together give the clearest answer.
After the scan
How Modassir’s plan changed
Before
An isolated hip diagnosis
After the scan
A whole-body, alignment-focused treatment approach
Instead of treating the hip on its own, his plan could take his pelvis and legs into account too. That gives whoever treats him, whether a physiotherapist or a surgeon, the full mechanical picture to plan from, rather than a view of one joint.
It also means each problem is treated in context. Care aimed only at the hip may not help a lower back that is working hard to compensate. Care aimed only at the back may not help a hip that is taking uneven load.
ScanAlign is a diagnostic imaging clinic. We show you what is going on and explain it clearly. Treatment is planned by the specialists you choose, with the findings in hand.
Why standing matters
Why a standing scan made the difference
A leg length difference, and the tilt it causes, is about how you stand. The standing scan captured both legs, the pelvis and the spine together under Modassir’s own weight, so the link between them was visible in one image.
Lying down takes the load off, so the same imbalance can flatten out and look normal. That does not mean the pain only happens when you stand. Many people hurt lying down too. It means the cause often sits in how you are aligned and loaded when upright and carrying your weight.
EOS is a full-body weight-bearing scan in 15 seconds, unstitched and non-magnified, with front and side views captured at the same time. It uses about 90% less radiation than a standard X-ray, around ten times less.
Lying down: MRI and CT
The load comes off
Muscles relax and the body settles into the table. A tilt or a difference in leg length can soften or disappear. These scans are excellent for discs, nerves and soft tissue.
Standing: EOS
Your real working position
Leg length, pelvic level and spinal curves show as they are when you carry your weight. Head to feet in one image, front and side together.
An honest note about MRI. EOS shows bones, joints and alignment. If your problem is mainly discs, nerves or soft tissue, MRI is usually the better tool, and we will tell you so on your free call. See how EOS compares with MRI, CT and X-ray.
Seek urgent help first if you have new numbness, weakness in your legs, or loss of bladder or bowel control. Contact your GP, NHS 111 or A&E.
Your story
Could your pain follow the same pattern?
Questions to ask your specialist
Whoever is treating you, these questions can open up the bigger picture.
- Has anyone measured my leg length while I am standing?
- Does my pelvis sit level when I stand, and could that affect my hip?
- Could my hip pain and my back pain be connected?
- Would a standing, full-length image change the plan?
Good clinicians welcome these questions. If you are not sure who to ask, our guide on when to see a specialist can help.
How a story like Modassir’s starts
A free video consultation
Tell us what has been going on and what you have tried. No GP referral is needed, and we will say honestly whether a scan is likely to help.
Your standing scan at 19 Harley Street
You stand naturally, with light undressing, and the scan captures you from head to feet. Read what to expect on the day.
A clear written report
A plain-English report of your findings, with a summary you can take to your GP, physiotherapist or specialist.
Questions
Questions people ask after reading Modassir’s story
Can a leg length difference cause hip and lower back pain?
It can. When one leg is shorter, the pelvis sits lower on that side, so the hip and lower back carry weight at an uneven angle. Not every leg length difference causes pain, which is why it helps to see it alongside the rest of your alignment.
If my hip is worn, is alignment still worth checking?
Yes. Wear in a joint is real, but it does not always explain every symptom. Seeing how your pelvis, legs and spine carry load shows whether other factors are adding strain, which can change the conversation about treatment.
How can I tell if my legs are different lengths?
Signs include one hip or shoulder sitting higher, clothes hanging unevenly, or a feeling that you lean to one side. A measurement taken while you stand, on a full-length image, is the most reliable way to know.
Is a leg length difference always in the bones?
No. Sometimes the bones are different lengths. Sometimes the legs are the same length but the pelvis sits unevenly, which makes one leg act shorter. A standing, full-length image helps tell the two apart, which matters because they are managed differently.
What does a whole-body approach mean?
It means looking at how the whole chain, from your feet to your head, carries weight, not just the joint that hurts. The findings can then guide the specialists treating you.
Is the EOS scan safe?
Yes. EOS uses about 90% less radiation than a standard X-ray, around ten times less. You stand in an open scanner, with no tunnel and no injections. There is more detail on our safety page.
Does ScanAlign treat the problem?
No. ScanAlign is a diagnostic imaging clinic. We show you what is going on and explain it clearly. Where it helps, we point you to trusted specialists, such as physiotherapists or surgeons, who can plan treatment with your findings in hand.
How much does it cost?
Prices are on our cost page. The first video consultation is free and there is no obligation to go ahead.
Keep reading
Guides linked to Modassir’s findings
- GuidePelvic tiltThe types of pelvic tilt and how they are assessed standing.Read the guide
- GuideGait analysisHow the way you walk affects your joints.Read the guide
- GuideHip replacement surgeryWhat to expect before, during and after surgery.Read the guide
- GuideBody alignment guideHow the body works as a connected chain, from feet to head.Read the guide
Your story
Recognise something in Modassir’s story?
If your hip and back both hurt, or one diagnosis does not explain everything, a free video consultation is the easiest way to find out whether a standing scan could help you too.
Modassir’s story, first name and scan video are shared with his permission. Individual findings and care plans vary, and this story does not predict your results.
This page is general information and not a diagnosis.
ScanAlign is the trading name of CoreMed Solutions Ltd and operates under The Harley Street Hospital’s CQC licence.