Diseases of the musculoskeletal system in almost all cases are accompanied by dysfunction of its organs, which causes great inconvenience to the patient.
An important symptom of pathologies of the musculoskeletal system is pain. Joint injuries are particularly uncomfortable.
The hip is the largest of them. Pain in case of defeat can be both localized around it and transmitted to various anatomical structures: to the organs of the small pelvis, lower back or thigh.
General classification of causes
The etiology of hip pain is diverse.
In medicine, the following causes of arthralgia are conditionally distinguished:
- Inflammatory and infectious processes within the joint and surrounding tissues.
- Degenerative diseases of the musculoskeletal system.
- injuries.
- Bone and soft tissue growth.
There are other specific causes of arthralgia:
- piriformis syndrome. Associated with her ongoing spasm.
- Femoral Head Necrosis (GBC). Most often it is a complication of another pathology of TBS.
- Legg-Calve-Perthes disease. It is osteochondropathy of GBC.
- Dissection of osteochondrosis. In various sources it can be referred to as Koenig's disease.
- Diabetic osteoarthropathy. complications of diabetes.
- pseudogout. Also chondrocalcinosis.
- Intermittent hydration is an overproduction of synovial fluid.
- Synovial chondromatosis (Lotsch syndrome).
The leg in the area of the hip joint often hurts in pregnant women.
During this time complex hormonal changes occur, the growing uterus displaces neighboring organs and puts strain on the ligaments of the hip joint. In addition, weight gain increases the load on the legs. If dietary recommendations are not followed, a pregnant woman can develop a calcium deficiency as this mineral imbalance disrupts the structure of bones and joints.
causes of pain
The prevalence of arthralgia increases with age.In children, symptoms of TBS disease (hip joint) occur with a frequency of no more than 10%, and in the elderly with a frequency of 50%. Most often women suffer from this pathology. This is due to age-related hormonal changes after menopause.
Why does the hip joint hurt? There is no definite answer to this question, as the list of reasons is quite long.
The main factors that cause arthralgia in the hip joint:
- Pathological process in the musculoskeletal system. Most often this is a consequence of direct mechanical impact: a contusion of the joint with subsequent inflammation of its components.
- Anatomical changes in the joint. They can be congenital or post-traumatic (dislocations, fractures).
- Pathology of other systems. Inflammation of the MT (small pelvis) organs can spread to the pelvic bones. Neurological disorders are manifested by pain of any localization. Metabolic disorders cause a mineral imbalance. The bone-ligament connection weakens and the risk of injury increases.
Inflammatory and infectious processes in the joints and surrounding tissues
The most common cause of arthralgia of any localization is suppuration of the musculoskeletal system.
Inflammation in the hip joint is divided into:
- Primary. It occurs as a result of direct penetration of pathogens into the joint: a blow with a sharp or blunt object with wound formation.
- Secondary. TBS infection occurs from a remote source of inflammation: by contact or by hematogenous routes.
Arthritis TBS
Mostly occurs in elderly patients.Pain in the hip joint, aggravated by walking, radiating to the groin, perineum and thigh. It is difficult for the patient to get up from a chair or climb stairs without help. Complaints worse in the morning.
Therapy involves taking anti-inflammatory drugs and introducing glucocorticoids into the intra-articular bursa. If necessary, its cavity is emptied.
Rheumatoid Arthritis (RA)
This is a chronic systemic connective tissue disease similar to polyarthritis.The essence of this pathological process is inflammation of the synovial membrane, cartilage and joint capsule. The reason is a malfunction of the immune system. Characterized by polyarthralgia, morning stiffness of movements, high fever possible.
The shoulder and hip joints are extremely rarely affected, and pain occurs only at a late stage of RA, several years after the onset of the disease.
Acute septic arthritis
This is a contagious childhood disease, 70% of cases occur in babies under 4 years old. The causative agent is usually Staphylococcus aureus. The child refuses to walk because of severe acute pain in the hip joint and groin when moving. Characterized by high fever and increased excitability.
Treatment includes removal of the effusion from the joint cavity and antibiotic therapy.
The risk of developing osteomyelitis and sepsis is high.
Tubercular coxitis or arthritis
Most often, pediatricians are faced with this disease. In young children, the immune system is poorly developed, which leads to a risk of infection.
This disease is characterized by slow progression. Initially, the child gets tired very quickly, his activity decreases, he stops walking. Gradually, atrophy of the thigh muscles occurs. Movements are hampered. Pain in the hip joint in a child acquires an intense pain character, the limb becomes longer than a healthy one.
When pus melts the synovial membrane, the exudate spreads along the muscles and tendons, forming phlegmon and fistulas.
In the absence of complications, conservative treatment is carried out.
Tendovaginitis in the region of the hip joint
This pathology is inflammation of the tendon of the muscle and its vagina. Caused by prolonged overuse or injury to the leg.
The main complaints: the thigh joint hurts when moving, the lesion swells, changing gears - lameness is noticeable.
Treatment - medication: anti-inflammatory drugs, intra-articular injections of corticosteroids.
bursitis
Of all the synovial sacs, the acetabular bursa is the most commonly inflamed.It partially covers the femur. With hip bursitis, the pain radiates to the thighs and buttocks. The patient cannot lie on the affected side: the pressure in the synovial sac increases and the pain intensifies.
If there are no complications from bursitis, treatment consists of relieving the load on the lower limb with a cane or crutch.
Medications: Pain relievers and corticosteroids.
Idiopathic ankylosing spondylitis
This is chronic inflammation of the spine and elements of the sacroiliac joints.
The disease is dangerous because of its complications, which reduce living standards and lead to disability.
If you find such a problem, you should immediately contact a specialist to arrange the right treatment.
The etiology is not fully understood. Modern medicine suggests that the main cause is hereditary predisposition. It is most common in people under the age of 30.
Symptoms of Idiopathic Ankylosing Spondylitis:
- Increased body temperature, fever.
- Intoxication syndrome: general malaise, weakness, loss of appetite, weight loss, sleep disturbances.
- Constant dull pain in the hip joint and at the level of the sacrum and buttocks, spreading along the back of the thigh. Usually bilateral, their intensity increases at night.
- Limited mobility in the lower back and hips. This symptom gradually spreads to the overlying sections of the spine along the entire back, including the neck. This causes the patient to assume a forced "pose of the supplicant".
Rehabilitation therapy is based on special physiotherapeutic exercises for the development of the joints.
Medications: NSAIDs to reduce pain and inflammation, corticosteroids.
tendinitis
Athletes or people whose work involves heavy physical labor are prone to tendinitis. Feature of the manifestation: pain in the hip joint occurs with a large load. At rest, discomfort is usually not observed.
It is recommended to reduce the load on the leg in advanced cases - bed rest.
Drug treatment: NSAIDs, topical analgesic gels, glucocorticosteroids, chondroprotectors.
syphilis
In the late stages of the disease, bones and joints are affected. The formation of gum is characteristic. Their excessive pathological mineralization occurs. TBS is extremely rare.
Gumma - a knot in tissue formed during advanced syphilis that destroys surrounding tissue. The process ends with the formation of rough scars.
Treatment is ineffective, the risk of developing complications in the form of osteomyelitis is high.
fungal arthritis of the hip
It occurs as a result of prolonged use of antibiotics and with pathologies of the immune system.
People who are infected with HIV or have AIDS are particularly susceptible to fungal arthritis.
Pain in the joint is constantly present, has an aching character.
Fungal lesions of the bones are characterized by a tendency to fistula formation, duration and difficulty of treatment.
Therapy: systemic antimycotics.
Depending on the indication, surgical intervention is performed.
Bone and soft tissue tumors
Oncological diseases of the hip joint can be metastases from cancer of a distant organ or arise independently.
- Benign tumors of bone tissue - osteomas.
The foreign formation grows and squeezes the nerves and blood vessels. The clinic is similar to piriformis syndrome.
- Malignant bone tumors - osteosarcomas.
The neoplasm rapidly increases in size, becomes necrotic and disperses, spreading metastases throughout the body.Pain in the hip joints at night is unbearable, it does not stop even after taking NSAIDs or trying anesthesia.
- Mesenchymal tumors are formed from soft tissues. Benign ones rarely recur and do not metastasize. The intensity of pain varies depending on the aggressiveness of malignant cells.
Degenerative diseases of the joint
coxarthrosis
Hip osteoarthritis is a chronic disease characterized by a change in the integrity of the articular surfaces due to a violation of metabolic processes. It develops very slowly, over several years. Cartilage tissue is affected first, then bone tissue, followed by varus deformity of the joint and limb. Occurs at the age of 40.
Symptoms:
- The hip joint only hurts when walking.
- Stiffness of movements in the TBS.
- In the further course, a shortening of the limbs is observed.
- Weakness and atrophy of muscle mass.
- lameness.
- A crunch is heard when walking.
- With a bilateral lesion, "duck gait" occurs - the transition from one leg to the other.
Medications: NSAIDs, vasodilators, muscle relaxants, chondroprotectors, injections of hormonal drugs into the joint cavity.
Local effects: ointments, lotions, compresses.
In the last stage of the disease, surgery is performed.
osteochondrosis
Degenerative changes in the intervertebral discs damage the surrounding tissue.
Symptoms:
- Pain in the lower back radiating to the hip joint and thigh.
- It's sudden, sharp and sharp. It starts in the lumbar region and buttocks and descends on the back of the leg.
- One-sided pain localization is more common.
- The patient takes a predicament - lying on a healthy side.
- Probably reduced sensitivity of the leg skin.
The treatment is complex. Anti-inflammatory drugs and analgesics, moderate physical activity (swimming), physiotherapy after the most acute symptoms have subsided.
With pronounced pain, it is recommended to perform anesthetic blockade.
injuries
injury
Pain of moderate intensity is characteristic, with active movements its intensity increases. The first time after an injury to the hip joint, lameness appears, which quickly passes.
Symptoms go away with rest.
To quickly get rid of pain from a pelvic joint injury, it is necessary to apply cold to the injury site: an ice pack or a frozen product.
hip dislocation
May be:
- Innate. It is the result of unsuccessful childbirth or pathologies of intrauterine development. The child has uneven buttock creases and shortening of the limb, possibly a pinched nerve, manifested by spasms. If the dislocation is not corrected in infancy, the child may become disabled later.
- traumatic. Signs: sharp severe pain, complete shutdown of joint function, massive edema and extensive hematoma appear over the damaged area. Getting up from a chair or bed becomes impossible for the patient without help.
In the event of a dislocated hip, you should go to the emergency room or hospital immediately.
fractures
The hip joint is made up of strong, strong bones.
The most common diagnosis from this subgroup is a fracture of the surgical neck of the femur. It is mainly given to women after 60 years.
Such damage is caused by a fall or impact in the area of the TBS.
The strongest pain is felt, the hip joint pulls and abscesses, movement in it is almost impossible. The thigh area swells, an extensive hematoma appears. The injured leg is shortened, the patient is limping. A characteristic click is heard when moving.
When a fracture occurs, the surrounding tissue is damaged, which is accompanied by a burning sensation. Without treatment, an inflammatory process can begin here. If the nerve is pinched, you may experience numbness in your thigh.
Treatment is complex: surgical and medical.
Specific causes of arthralgia
piriformis syndrome
With the localization of pathological processes in the area of \u200b\u200bthe hip joint, the surrounding tissues are also affected. A long-term spasmodic piriformis muscle compresses the sciatic nerve and its vessels, causing a number of symptoms:
- Pain in the leg around the hip joint. She goes to the buttocks and the lumbosacral joint.
- Increased discomfort when relying on the affected leg.
- Compression of the piriformis muscle.
- Sudden pain "lumbago" along the nerve.
Etiology: injuries and infectious and inflammatory diseases of the pelvic organs, vertebral pathologies, muscle overtraining, long-term maintenance of an unphysiological posture.
Medications: NSAIDs, muscle relaxants, analgesics, blood flow enhancers, glucocorticoids.
After the acute manifestations subside, rehabilitation measures can be prescribed: physiotherapy, massage, acupuncture.
Aseptic necrosis of the femoral head
The vast majority occurs in young men. The etiology of the disease is ischemia of the thigh. With insufficient blood supply to the tissues, there is a lack of oxygen and their necrosis (necrosis) begins.
Clinical picture: The hip joint is painful and the leg and perineum give way. Relying on the injured leg is not possible. After a few days, the nerve endings melt and the pain goes away. That's a terrible sign! With necrosis of the deeper bone layers, the risk of rapid development of osteomyelitis and sepsis is high.
Treatment consists of surgery and drug therapy.
Koenig's disease
Dissecting osteochondritis - exfoliation of a small area of necrotic cartilage from the bone and its protrusion into the joint cavity.
This is a rare disease. Typical for men between 15 and 35 years.
Patients complain of slight aching pain in the hip joint. The joint "sticks" when moving.
Treatment is conservative (duration 10-18 months) and surgical. During a surgical intervention, the exfoliated masses are removed, the congruence (comparability) of the articular surfaces is restored.
Diabetic osteoarthropathy
Violation of glucose metabolism leads to impaired blood circulation and innervation of all organs. Changes in the hip joint are more often unilateral: they occur more often on the right than on the left. The immune response is reduced, making it easier for the body to become infected.
Clinical picture:
- swelling of the joint.
- The skin above feels cold.
There is no such thing as a pain syndrome in diabetic osteoarthropathy!
Treatment consists of careful monitoring of blood sugar levels and timely administration of insulin.
pseudogout
This pathology is the deposition of calcium salts in the articular cartilage.
Doctors associate it with endocrine pathologies: hyperparathyroidism, diabetes, gout, etc.
Symptoms:
- Starting with acute pain in the hip joint.
Several types of calcium salts are known. With some of them (pyrophosphates) there is no pain.
- Movement in it is limited, leg abduction to the side is difficult.
- Edema and hyperemia are characteristic.
- Elevated body temperature and fever.
To date, there is no specific treatment. An acute attack is stopped by intra-articular administration of corticosteroids and NSAIDs.
Intermittent hydration
This is a chronic disease manifested by bouts of increased synovial fluid production. prone to frequent relapses.
It is mainly diagnosed in women between the ages of 20 and 40.
The etiology is unknown. There are two theories about the occurrence of this disease: related to injuries and caused by endocrine disorders.
The joint increases in size, becomes stiff.
Attacks pass by themselves in 3-5 days.
Drug treatment is ineffective. Relapses also occur after surgery.
Synovial chondromatosis
This benign metaplastic disease is the replacement of synovial collagen with cartilage. The structure of the articular surface changes, as do its properties.
The likelihood of developing chondromatosis is much higher in men, mostly middle-aged and older.
The etiology is unclear.
There is local swelling, reduced function of the joint, crunching during its work, arthralgia.
Treatment is surgical only.
Hip pain in children and adolescents
epiphyseolysis
This pathology is most typical for children during puberty (from 11 to 16 years old). At this point there is a strong growth spurt. Due to the weak growth zone, the HBA slides down the neck, causing discomfort in the hip joint.
The child feels pain in the thigh, which spreads to the groin and knee. Lameness is noted, but limb confidence is maintained.
The disorder is surgically corrected. You should start therapy as early as possible. Otherwise, slipping of HBA can provoke the development of osteoarthritis and inflammation of the joints.
dysplasia
It is an excessive formation of connective tissue that can replace bone elements. As a result, solid anatomical structures become plastic and flexible. Ligaments, menisci, and tendons become weak. An unstable hip develops, which is characterized by frequent dislocations.
Dysplasia is an inherited condition that usually occurs in infants between the ages of 3 months and 1 year. Orthopaedists easily cope with the correction of the leg position.
The latent form can show up in adolescence.
If you notice manifestations of clubfoot or foot deformity in a child, you need to quickly go to the hospital to examine the baby's musculoskeletal system!
The later dysplasia is detected, the more problematic is its treatment.
osteochondropathy
This group of diseases includes lesions of bone and cartilage tissues, in which the most stressed areas are subject to aseptic necrosis.
Etiology: genetic predisposition, hormonal imbalances and infections can provoke this pathology.
The hip joint is affected in 30% of cases. These are mainly childhood illnesses that often occur in adolescents during a growth spurt.
An adult at the initial stage should determine the localization and nature of the pain, contact a pediatrician and obtain the necessary information to prevent the development of complications.
Legg-Calve-Perthes disease
The syndrome is characterized by HBK necrosis in children under 15 years of age. The right hip joint is more commonly affected.
The cause of the pathological condition is a violation of blood circulation in the upper part of the leg with the addition of cartilaginous tissue to the process.
Clinical picture:
- Initially, the femoral head hurts. With the progression of necrosis, arthralgia suddenly disappears. This indicates the death of sensitive organ receptors.
- Change of gear - the child begins to limp.
- Movement in TBS is limited.
- Mostly one-sided.
Complications: dislocation, coxarthrosis, lower extremity deformity, muscle atrophy.
diagnostic measures
Before prescribing treatment, the doctor must carefully study the complaints and anamnesis, conduct an examination.
The following examinations are necessary for hip joint diseases:
- Laboratory blood tests (with inflammation, the ESR increases and leukocytosis is detected).
- Plain radiograph of the joint in two or more projections.
- MRI with or without contrast media.
- MSCT. It is used to check for the presence of a sarcoma.
- osteoscintigraphy. radionuclide method. The most common and informative type of bone tissue examination.
- Ultrasound of the hip joint.
- densitometry. Required to determine bone density and strength.
If the patient cannot sit or stand, and there is no point in relieving pain, he is immediately hospitalized for further surgical treatment.
When you urgently need to see a doctor
- If there is severe pain when moving the hip joint.
- When it is impossible to support the affected leg.
- Detection of edema of the lumbar and thigh region.
- Redness or bruising in the affected area.
There are folk ways to relieve pain in the pelvic joint. Relying on these tips for a quick cure isn't worth it. Without a thorough diagnosis, it is impossible to determine the cause of arthralgia, and self-medication leads to the development of complications.