Pain in both hips can be due to back condition or the disease of the hip affecting both hip joints. Bilateral hip joints being affected by a disease is less common than the single hip disease.
Pain in both hips should raise the suspicion of the possibility of following diseases
Avascular Necrosis of Hip
Avascular necrosis of the hip occurs due to attenuation of blood supply to the head of the femur. The exact cause of the disease is not known through an association with prolonged steroid use and alcoholism is known. The disease typically gets symptomatic in one hip and in quite a number of cases, imaging reveals that both the hips are involved.
Sometimes, the presentation may be the pain in both hips.
Rheumatoid Arthritis or Seronegative Arthropathies
These arthritides may are typically symmetrical and both hip involvement is known. Pain in both hips can occur in these arthropathies
Systemic Diseases Affecting Joints
Disorders of vitamin D deficiency or increase in parathyroid hormones may affect both the hips.
Developmental Dysplasia of Hip [DDH]
This congenital abnormality can be unilateral or bilateral. Uncorrected DDH can in later life lead to pain in both hips.
Perthes Disease
This disease is usually in the single hip but rarely can affect both hips simultaneously. It is a disease of childhood.
Slipped Capital Femoral Epiphysis
This is found in children near puberty and involves slippage of the upper femoral epiphysis.
Osteoarthritis
Hip osteoarthritis, primary and secondary, is a common cause of pain in both hips. Primary osteoarthritis occurs without any other factor and secondary osteoarthritis develop due to degeneration of hip due to some other disease.
Ankylosing Spondylitis
Ankylosing spondylitis commonly involves hip joints and usually symmetrical. A person with back pain and pain in both hips should be evaluated for ankylosing spondylitis as well.
Trauma
Trauma to both hips would result in pain in both hips. It is quite rare though.
Infection
Infection in both hips is extremely rare.
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