Arthropathy of the hip joint

Coxarthrosis(arthropathy of the hip joint) is a type of degenerative joint arthropathy, which is a chronic non-inflammatory disease that affects the hip joints (one or both at the same time). This disease has a degenerative-dystrophic character. This means that the cartilage that forms the hip joint undergoes degenerative changes, while the surfaces of the bones also change. Further, bony growths (osteophytes) are formed, the joint is deformed, the range of motion in the affected joint is reduced and they become extremely painful and uncomfortable.

The hip joint is one of the largest joints in our body. It is thanks to him that a very important motor function is performed in the human body and is also responsible for ensuring our body's ability to move. If the hip joint gets sick, then this affects the whole body as a whole and prevents a person from living peacefully, walking, not to mention sports. Very often we see elderly people who are forced to rely on a cane due to hip joint disease.

Despite the fact that the hip joint is extremely massive and strong, at the same time it is quite vulnerable, especially over time. Pain in the hip joints significantly reduces the quality of human life.

Coxarthrosis (arthropathy of the hip joint)it consistently ranks second among knee joints in terms of the frequency of diagnosed cases after gonoarthrosis (arthropathy of the knee joint).

Classification of coxarthrosis (arthrosis of the hip joint)

It happenscoxal jointboth primary and secondary.

• The cause of primary coxarthrosis is mainly the inevitable wear and tear of the hip joints during life and usually affects people after the age of 40.
• The causes of secondary coxarthrosis are usually the following diseases: congenital dislocation of the femur, necrotic masses of the hip bone in the area of its head, Peter's disease, injury to the previous hip joint, inflammatory diseases of the hip joint. Inarthropathy of the hip jointit can affect either one joint separately or both.

There are several types of coxarthrosis:

• Dysplastic (it is a congenital pathology and is characterized by underdevelopment of the joint).
• Cohesive (usual for people of an older age group and associated with age-related changes).
• Metainfectious (preceded by purulent or purulent-allergic, rheumatoid arthritis).
• Disease due to Peters disease (development of osteochondropathy in the femoral head).
• Coxarthrosisdue to trauma (fractures of the neck and head of the bone (femur)).
• Coxarthrosis due to metabolic disorders (metabolism).
• Dyshormonal (taking glucocorticosteroids, antidepressants for a long time).
• Idiopathic (the cause of which could not be ascertained).

Symptoms of coxarthrosis (arthropathy of the hip joint)

In order to correctly describe the symptoms of coxarthrosis, the stages of the disease should be considered simultaneously, because the symptomatology depends on the stage of the disease.

Stages of coxarthrosis (arthrosis of the hip joint)

Overall, there are three stages of coxarthrosis (arthrosis of the hip joint):

• 1st stage of coxarthrosis. This is the initial stage of the disease, in which the symptoms are still mild. The joint at this stage does not hurt much and pain occurs only after physical exertion, such as lifting heavy objects or running, hiking for long distances. After the person rests, the pain goes away. The patient may also experience lameness if, for example, he walks more than two kilometers on foot. Increases pain by climbing stairs. Joint motor volume is slightly reduced or maintained. X-ray can only show small changes in bone structures.
• 2nd stage of coxarthrosis. This stage develops in the absence of treatment of the first stage. To the above symptoms, a certain crack (crisp) in the joint is added. The pain becomes more intense and starts radiating to the groin and may also spread to the thigh and knee. At this stage, not only vigorous, but also any movements can cause pain symptoms, even a light load on the hip joint. Even getting out of bed or turning your trunk can cause pain. There is tension in the periarticular muscles, which does not subside even at night, so patients often complain that the thigh hurts at night. A person can start to limp even after short walks (up to 500 meters). At this stage, the disease already forces a person to rely on a cane when walking. The limitation of movements in the joint becomes more pronounced. According to the results of X-ray diagnosis, emerging osteophytes are determined.
• 3rd stage of coxarthrosis. The final stage of the disease. At this stage, the pain becomes permanent and torments the patient. Any movement, even the weakest, increases the symptoms of pain several times. At this stage, the hip joint is completely immobilized. Muscle mass in the thigh and buttocks is reduced due to muscular dystrophy, which is very noticeable. Characteristic is the patient's inability to stand straight, while the body will be tilted. Any arthropathy leads to the formation of a contracture (bend position), in this case, the contracture is also formed due to the fact that the muscle fibers are in constant tension, while the leg on the side of the lesion becomes shorter. As a result of the fact that the hip joint is immobilized, the entire leg ceases to perform its motor function, which has a very negative effect and leads to their osteochondrotic damage. In addition, the spine also suffers, there are sensations of discomfort and pain in the sacral area.

Causes of coxarthrosis (arthrosis of the hip joint)

The main causes of coxarthrosis:

• Age-related changes in the joint. Typical for seniors. The hip joint wears out over time, ceases to perform its functions over time, "dry", which leads to a decrease in the shock-absorbing function and friction of the bones that form the joint against each other.
• Injury to the hip joint. The most common injury among people of this age group is a fracture of the neck of the femur, which threatens with disability in the absence of proper treatment. The joint can be injured at any age, but older people are more likely to suffer.
• Disturbed metabolism. This is typical for people with a history of metabolic disorders and diseases associated with reduced metabolism.
• Violation of hormonal status. It is more typical for women, especially those who take antidepressants and glucocorticosteroids for a long time.
• Hereditary anomalies in the development of the musculoskeletal system, as well as congenital anomalies. Unfortunately, at this time a fairly large number of children are born with congenital pathologies of the musculoskeletal and nervous system. As for abnormalities in the development of the hip joint, this can include hip dysplasia, in which many structures of the joint do not develop.
• Systemic arthritis. Damage to multiple joints can also lead to damage to the hip joint. In this case, one of the main risk factors will be the presence of an inflammatory process.
• Rheumatic diseases and chronic arthritis. All these can also lead to the appearance of pain in the hip joint. Such diseases that cause joint pain studied include: rheumatism. rheumatoid arthritis; spondyloarthropathy; juvenile rheumatoid arthritis.
• The defeat of osteochondrosis. Osteochondrosis of the spine is a fairly common and serious disease that, in addition to the spine, can "disable" other structures in our body, especially the hip joint.
• Muscles and ligaments of the joint. Damage to these structures can also be the result of degenerative and dystrophic processes in the hip joint.
• Infectious lesions of both the joint itself and the femur. Such damages are very serious, because they lead to serious consequences and are sometimes difficult to treat. Osteomyelitis can occur, which simply "eats" or "dissolves" the bone tissue. Tubercular lesions may also appear, and more often such localization occurs in children of the preadolescent period. Abscess in the pelvic area, which is most often the result of an untreated or poorly treated infectious process, for example, with appendicitis, inflammatory processes, especially when it comes to the female genital organs (ovarian disease), growthabscess in the region of the sciatic notch, which leads to impaired walking (appearance of lameness). In most cases, pain and lameness are the result of compression or damage to nearby nerves (sciatic or obturator).
• Neoplasms of a malignant nature. Very rarely, malignant neoplasms affect the hip joint and the bones surrounding it, because more often the cause of the disease is metastasis from other malignant areas, for example, with breast or lung cancer.
• Narrowing of the lumen of the aorta and iliac arteries (narrowing and occlusion thereof). At the same time, the joint receives less and less nutrients necessary for normal functioning, which leads to its degeneration.

Risk group for coxarthrosis (arthropathy of the hip joint)

The main risk group may include the following categories of people and harmful factors:

• Older people. This disease is typical for the elderly, the elderly, because degenerative processes occur that occur precisely in this age period.
• Female. According to statistics, women are more prone to hip joint problems.
• People who are overweight or obese.
• Previous trauma to one or both hip joints.
• Hereditary predisposition to this type of disease and congenital abnormalities in the development of the hip joint.
• The presence in the past of infectious lesions, such as abscesses, aseptic necrosis of the head of the hip bone, osteomyelitis, etc.
• Hard physical work.
• Summer residents who have an extremely high risk of coxarthrosis.

Prevention of coxarthrosis (arthropathy of the hip joint)

The main measures to prevent coxarthrosis are the following:

• Dosed physical activity. It is important to exercise and knead the joint to prevent the development of pathological processes in it and to slow down its aging. This will help not only to improve the condition of the hip joint, but also the whole body.
• If there are metabolic disorders, they should be corrected. To do this, you should contact a specialist.
• Watch your weight. Do not forget that the hip joint already carries a large load, almost the entire body, so you should not interfere with it to perform its functions. In addition, the heavy weight will put so much pressure on the joints that they will gradually collapse. Overweight people are also prone to metabolic disorders.
• Avoid sudden turns of the body, especially if you are not warmed up and prepared, this will prevent you from injuring the head and neck of the femur.
• It is better, of course, to choose the sport in which the least dangerous joint injuries, such as swimming or yoga, especially if there are hereditary predispositions or developmental anomalies.
• Predisposition to joint diseases implies careful handling of them, as well as regular trips to the doctor so as not to miss the possible development of a disease or any other pathological process in the joint.
• If a child is diagnosed with hip dysplasia, it should be treated, and treated immediately! It is better to let the child be immobilized for a few weeks at an early age than to suffer all his life.
• Timely treatment of infectious diseases, especially those that threaten to spread to the hip joint.

Diagnosis of coxarthrosis (arthropathy of the hip joint)

When diagnosing coxarthrosis, it is very important to find the cause that caused it. Besides, as we have already discussed above, there are many reasons, they are different andhip osteoarthritis treatment, respectively, will differ radically. Sometimes it's not that easy, and sometimes it's not possible at all. Emphasis is placed on studying the manifestations of the disease and choosing the appropriate treatment.

First of all, the patient is carefully interviewed by the doctor, studying in detail the complaints, the causes of the disease, the hereditary burden, the presence of injuries, etc. It is very important to have the complaints described above and how long they have been observed in the patient.

After the interview, the doctor personally examines the affected area for the presence of inflammatory changes, trophic, deformities, shortening of the limbs, asymmetries, etc. Children can also have a "click" symptom.

An important point is additional examination methods - computed tomography and magnetic resonance imaging, ultrasound and X-ray examination, because they will help in the final diagnosis. In the differential diagnosis of coxarthrosis from other diseases of the hip joint, this element is extremely important.