OBJECTIVES: To evaluate costs related to health care resource use and PRO in German patients with chronic knee and/or hip pain, specifically for guideline-, non-guideline- and self-treatment-groups. METHODS: Patients (n=126) were consecutively recruited by physicians in general practice (n=49) in 2005 and categorized into the three groups (n=61 self-treatment, n=19 guideline-, n=46 non-guideline-groups). PRO were assessed by SF-36, von Korff Index, and Patient Health Questionnaire Depression (PHQ-D) questionnaires at time of enrollment. Resource utilization data was collected retrospectively for six months. Groups were compared using multivariate general linear modeling (GLM). RESULTS: Participants had an average duration of knee and/or hip pain of about 5.4 years, were on average 60 years old, predominantly females (71%), overweight (mean BMI 27.8 kg/m2) and unemployed (69%). Patients with self-treatment were younger compared to guideline- or non-guideline patients (54.4 vs. 63.7 vs. 65.5 years, mean age, p=0.0070). Regarding SF-36, von Korff Index, and PHQ-D (with exception of major depressive symptoms) the groups were similar. Mean total societal perspective costs per patient were €210.22 [95%CI 77.47; 342.97] vs. €2886.07 [95%CI 107.93; 5664.21] vs. €1087.50 [95%CI 600.73; 1574.27] (self-treatment- vs. guideline- vs. non-guideline-group, respectively, p=0.0686, adjusted by age and employment status). The major cost factors were: in the self-treatment-group, hospitalizations, remedies, and sport activities (29.3%, 27.9%, and 21.9% of the mean total cost per patient, respectively); in the guideline-group, hospitalizations, sick leaves, and remedies (25.8%, 24.6%, and 19.6%, respectively); and for the non-guideline-group, remedies, hospitalizations, and visits to physicians (19.8%, 19.0%, and 13.7%, respectively). CONCLUSIONS: PRO in patients with chronic knee and/or hip pain are worse compared to the general reference population in Germany. However, PRO and societal mean total adjusted costs per patient with knee and/or hip pain are comparable among guideline-, non-guideline- and self-treatment-groups.