Diseases that cause pain in the hip joint

Diseases of the musculoskeletal system in almost all cases are accompanied by dysfunctions of its organs, which cause a lot of inconvenience to the patient.

An important symptom of musculoskeletal disorders is pain. Joint injuries are particularly unpleasant.

The hip is the largest of them. Pain in case of its defeat can be localized both around it and give it to various anatomical structures: to the organs of the small pelvis, lower back or thigh.

General classification of causes

The etiology of hip pain varies.

In medicine, the following causes of arthralgia are conditionally distinguished:

• Inflammatory and infectious processes within the joint and its surrounding tissues.
• Degenerative diseases of the musculoskeletal system.
• Injuries.
• Neoplasms of the bones and soft tissues.

There are additional specific causes of arthralgia:

• Piriformis syndrome. Associated with his prolonged spasm.
• Femoral head necrosis (GBC). Most often it is a complication of another TBS pathology.
• Legg-Calve-Perthes disease. It is GBC osteochondropathy.
• Osteochondrosis dissecans. In several sources it can be called Koenig's disease.
• Diabetic osteoarthropathy. Complication of diabetes.
• Pseudologist. Also chondrocalcinosis.
• Intermittent hydarthrosis is an overproduction of synovial fluid.
• Synovial chondromatosis (Lotsch syndrome).

In addition, the leg in the hip joint area in pregnant women often hurts.

During this period, complex hormonal changes occur, the growing uterus displaces neighboring organs and strains the ligament apparatus 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 lack of calcium, due to this mineral imbalance, the structure of the bones and joints is disturbed.

Causes of pain

The prevalence of arthralgia increases with age.In children, symptoms of TBS (hip joint) disease occur with a frequency of no more than 10%, and in the elderly - from 50%. Mostly women suffer from this pathology. This is due to age-related hormonal changes after menopause.

Why does the hip joint hurt? There is no definitive answer to this question, as the list of reasons is quite long.

The main factors causing arthralgia in the hip joint:

1. Pathological process within the musculo-ligament apparatus. Most often, this is a consequence of direct mechanical action - a bruise of the joint with subsequent inflammation of its components.
2. Anatomical changes in the joint. They can be congenital or post-traumatic (dislocations, fractures).
3. Pathology of other systems. Inflammation of the TM organs (small pelvis) can spread to the pelvic bones. Neurological disorders are manifested by pain of any localization. Metabolic disorders cause mineral imbalance. The bone-ligament connection weakens, 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 joint.

Inflammation of the hip joint is classified into:

1. Primary. It is formed with the direct penetration of pathogens into the joint - a blow with a sharp or blunt object with the formation of a wound.
2. Secondary. TBS infection occurs from a distant focus of inflammation: by contact or by the hematogenous route.

TBS arthritis

It occurs mainly in elderly patients.Aching pain in the hip joint, aggravated by walking, radiates to the groin, perineum and thigh. It is difficult for the patient to get up from a chair or climb stairs without assistance. The discomfort gets worse in the morning.

Therapy involves taking anti-inflammatory drugs and introducing glucocorticoids into the intraarticular bursa. If necessary, its cavity is drained.

Rheumatoid arthritis (RA)

This is a chronic systemic connective tissue disease similar to polyarthritis.The essence of this pathological process is inflammation of the synovium, cartilage and joint capsule. The reason is a dysfunction of the immune system. Characterized by polyarthralgia, stiffness of movements in the morning, high fever is possible.

The shoulder and hip joints are very rarely affected, pain appears only in an advanced stage of RA after a couple of years from the onset of the disease.

Acute septic arthritis

This is a childhood infectious disease, 70% of cases occur in children under the age of 4. The causative agent is usually Staphylococcus aureus. The child refuses to walk due to sharp sharp pain in the hip joint and groin during movement. Characterized by high fever and increased excitability.

Treatment involves removal of the effusion from the joint cavity and antibiotic therapy.

The risk of developing osteomyelitis and sepsis is high.

Tuberculous coxitis or arthritis

Most often, pediatricians face this disease. In young children, the immune system is underdeveloped, which leads to the possibility of infection.

This disease is characterized by slow progression. Initially, the child gets tired very quickly, his activity decreases, he stops running. Gradually, atrophy of the thigh muscles occurs. Movements are hampered. Pain in the hip joint in a child acquires an intense aching character, the limb becomes longer than the healthy one.

If the pus dissolves 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 area of the hip joint

This pathology is inflammation of the tendon of the muscle and its vagina. Caused by prolonged overuse or leg injury.

The main complaints: the femoral joint hurts when moving, the lesion swells, the change in gait - lameness becomes noticeable.

Treatment - drugs: anti-inflammatory drugs, intra-articular injections of corticosteroids.

Bursitis

Of all the synovial bursae, the acetabulum bursa is most often inflamed.Partially covers the femur. With hip bursitis, the pain radiates to the thigh and buttock region. The patient is unable to lie down on the affected side: the pressure in the synovial sac increases and the pain intensifies.

If there are no complications with bursitis, treatment consists of relieving the lower limb with a cane or crutch.

Medicines: pain relievers and corticosteroids.

Idiopathic ankylosing spondylitis

This is a chronic inflammation of the spine and elements of the sacroiliac joints.

The disease is dangerous due to its complications that reduce the standard of living and lead to disability.

If you find such a problem, you should immediately contact a specialist for the appointment of the correct treatment.

The etiology is not entirely clear. Modern medicine suggests that the main cause is hereditary predisposition. Very often people under 30 get sick.

Symptoms of idiopathic ankylosing spondylitis:

• Increased body temperature, fever.
• Intoxication syndrome: general malaise, weakness, lack of appetite, weight loss, sleep disturbances.
• Constant dull pain in the hip joint, as well as in the sacrum and buttocks, which spreads along the back of the thigh. Usually bilateral, their intensity increases at night.
• Limited mobility in the lower back and hips. This symptom gradually passes to the overlying sections of the spine along the entire back, including the neck. As a result, the patient assumes a forced "signatory position".

Rehabilitation therapy is based on special physiotherapy exercises for joint development.

Medicines: NSAIDs to relieve pain and inflammation, corticosteroids.

Tendinitis

Athletes or people whose work is associated with strenuous physical work are prone to inflammation of the tendons. Characteristic of the manifestation: aching pain in the hip joint occurs with a large load on it. At rest, discomfort is usually not observed.

It is recommended to reduce the load on the leg, in advanced cases - bed rest.

Drug therapy: NSAIDs, topical analgesic gels, glucocorticosteroids, chondroprotectors.

Syphilis

In the advanced stage of the disease, the bones and joints are affected. The formation of gum is characteristic. Their pathological excessive mineralization occurs. TBS is extremely rare.

Gumma - a knot in the tissues, formed during advanced syphilis, which destroys surrounding tissues. 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 infected with HIV or with AIDS are particularly susceptible to fungal arthritis.

Pain in the joint is constantly present, has a painful character.

Fungal lesions of the bones are characterized by a tendency to fistula formation, duration and difficulty of treatment.

Therapy: systemic antifungals.

According to the indications, surgical intervention is performed.

Tumors of the bones and soft tissues

Oncological diseases of the hip joint can be cancer metastases of a distant organ or arise independently.

1. Benign tumors of bone tissue - osteomas.

   The foreign formation in the body grows, compressing the nerves and blood vessels. The clinic is similar to piriformis syndrome.

2. Malignant bone tumors - osteosarcomas.

   The tumor rapidly increases in size, becomes necrotic, and disintegrates, spreading metastases throughout the body.The pain in the hip joints at night is unbearable, they don't stop even after taking NSAIDs or trying to anesthetize.

3. Mesenchymal tumors are formed from soft tissues. Benign ones rarely recur and do not metastasize. Depending on the aggressiveness of the malignant cells, the intensity of the pain is variable.

Degenerative diseases of the joint

Coxarthrosis

Arthrosis of the hip is a chronic disease characterized by a change in the integrity of the joint surfaces, due to a violation of metabolic processes. It develops very slowly, over several years. Cartilage tissue is first affected, then bone tissue, followed by varus deformity of the joint and limb. It occurs at the age of 40.

Symptoms:

• The hip joint only hurts when walking.
• Stiffness of movements in the TBS.
• As the process progresses, a shortening of the length of the limb is observed.
• Weakness and atrophy of muscle mass.
• lameness.
• When walking, a creak is heard.
• With a bilateral injury, a "duck gait" occurs, moving from one leg to the other.

Medicines: 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 underway.

Osteochondrosis

Degenerative changes in the intervertebral discs cause damage to surrounding tissues.

Symptoms:

• Pain in the lower back that radiates to the hip joint and thigh.
• It is sudden, sharp and acute. It starts in the lower back and buttocks, goes down the back of the leg.
• Unilateral localization of pain is more common.
• The patient takes a forced position - lying on his sound side.
• The sensitivity of the skin on the leg has probably decreased.

The treatment is complex. Anti-inflammatory and analgesic drugs, moderate physical activity (swimming), physiotherapy after the disappearance of the most acute phenomena.

With pronounced pain, it is recommended to perform an anesthetic block.

Injuries

Injury

Pain of moderate intensity is characteristic, during active movements its intensity increases. The first time after the hip joint injury, lameness appears, which quickly passes.

At rest, the symptoms disappear.

To quickly get rid of pain in the event of a pelvic joint injury, it is necessary to apply cold to the injury site - an ice pack or a frozen product.

hip dislocation

Perhaps:

• Congenital. It is the result of unsuccessful childbirth or intrauterine developmental pathologies. The child has irregular gluteal folds and a shortening of the limb, possibly a pinched nerve, manifested by seizures. If the dislocation is not corrected in childhood, the child may later become disabled.
• Traumatic. Signs: severe acute pain, complete arrest 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 assistance.

If you have a hip dislocation, you should go to the emergency room or hospital immediately.

fractures

The hip joint is made up of strong and powerful bones.

The most common diagnosis of this subgroup is a surgical neck fracture of the femur. It is mainly worn on women over 60.

The cause of this damage is a fall or impact in the TBS area.

The strongest pain is felt, the hip joint pulls and abscesses, movement is almost impossible. The area of the upper thigh swells, an extensive hematoma appears. The injured leg is shortened, the patient limps. A characteristic click is heard when moving.

When a fracture occurs, the surrounding tissues are damaged, which is accompanied by a burning sensation. In the absence of treatment, an inflammatory process can begin here. If the nerve is pinched, you may experience a numb feeling 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 the 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 in the region of the hip joint. It goes to the buttocks and lumbosacral joint.
• Increased discomfort when relying on the affected leg.
• Compaction of the piriformis muscle.
• Sudden "low back" pain along the nerve.

Etiology: injuries and infectious and inflammatory diseases of the pelvic organs, vertebrogenic pathologies, muscle overtraining, long-term preservation of a non-physiological posture.

Drugs: NSAIDs, muscle relaxants, analgesics, blood circulation improvers, glucocorticoids.

After the disappearance of acute phenomena, rehabilitation measures can be prescribed: physiotherapy, massage, acupuncture.

Aseptic necrosis of the femoral head

The vast majority occur in young men. The etiology of the disease is ischemia of the upper thigh. With insufficient blood supply to the tissues, their oxygen starvation occurs and their necrosis (necrosis) begins.

Clinical picture: the hip joint hurts and gives way to the leg and perineum. It is not possible to rely on the injured leg. After a few days, the nerve endings dissolve and the pain disappears. This is a terrible sign! With necrosis of the deeper layers of the bone, the risk of rapid development of osteomyelitis and sepsis is high.

Treatment is surgery and drug therapy.

Koenig's disease

Osteochondritis dissecans - exfoliation of a small necrotic cartilage area from the bone and its protrusion into the joint cavity.

This is a rare disease. Typical for men 15-35 years old.

Patients complain of mild aching pain in the hip joint. The joint "sticks" while moving.

Treatment is conservative (10-18 months) and surgical. During surgery, exfoliated masses are removed, congruence (comparability) of the articular surfaces is restored.

Diabetic osteoarthropathy

Violation of glucose metabolism leads to circulatory disorders and innervation of all organs. Changes in the hip joint are more often one-sided: on the right it occurs more often than on the left. The immune response is reduced, which makes it easier for the body to get infected.

Clinical picture:

• Swelling of the joint.
• The skin on top is cool to the touch.

There is no pain syndrome in diabetic osteoarthropathy!

Treatment consists of careful monitoring of blood glucose levels and prompt administration of insulin.

pseudogout

This pathology is the deposition of calcium salts in the joint 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, abduction of the leg to the side is difficult.
• Edema and hyperemia are characteristic.
• Increased 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 hydrarthrosis

This is a chronic disease, manifested by attacks of increased production of synovial fluid. 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 onset of this disease: associated with injury and caused by endocrine disorders.

The joint increases in size, becomes stiff.

Attacks pass on their own in 3-5 days.

Medical 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 joint surface changes, as does its properties.

The chance of getting chondromatosis is much higher in men, mostly middle-aged and elderly.

The etiology is unclear.

There is local swelling, limited function of the joint, crunching during its work, arthralgia.

Treatment is surgical only.

Hip pain in children and adolescents

epiphysiolysis

This pathology is more typical for children during puberty (11 to 16 years). Right now, there is a strong growth leap. Due to the weak growth zone, the HBA slips up the neck, causing discomfort in the hip joint.

The child feels pain in the thigh, which passes to the groin and knee. Lame is noted, but dependence on the limb is maintained.

The disorder is surgically corrected. You should start therapy as soon as possible. Otherwise, the slippage of the HBA can cause 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, flexible. The ligaments, menisci and tendons are weakened. An unstable hip is formed, which is distinguished by frequent dislocations.

Dysplasia is an inherited disease that usually occurs in babies from 3 months to 1 year. Orthopedists can easily cope with the correction of the setting of the legs.

The latent form can manifest itself in adolescence.

If you notice any manifestations of clubfoot or foot deformity in a child, you need to quickly go to the hospital for an examination of the child's musculoskeletal system!

The later dysplasia is detected, the more problematic its treatment is.

Osteochondropathy

This group of diseases includes lesions of bone and cartilage tissue, in which the most loaded areas undergo aseptic necrosis.

Etiology: genetic predisposition, hormonal imbalances and infections can cause this pathology.

In 30% of cases, the hip joint is affected. These are mainly childhood diseases that are common in adolescents during the growth spurt.

An adult should at the initial stage 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 the age of 15. The right hip joint is most commonly affected.

The cause of the pathological condition is a violation of blood circulation in the upper leg with the addition of cartilage tissue to the process.

Clinical picture:

• Initially, the head of the femur hurts. With the progression of necrosis, arthralgia suddenly disappears. This indicates the death of the receptors of the sensitive organs.
• Change in gait: the child begins to limp.
• Movement in TBS is limited.
• Most often one-sided.

Complications: dislocation, coxarthrosis, deformity of the lower limb, muscle atrophy.

Diagnostic measures

Before prescribing treatment, the doctor must carefully study the complaints, anamnesis and conduct an examination.

In case of hip joint disease, the following studies are needed:

• Laboratory blood tests (with inflammation, ESR increases and leukocytosis is noted).
• Normal radiograph of the joint in two or more views.
• MRI with or without contrast.
• MSCT. It is used to check for a sarcoma.
• Osteoscintigraphy. radionuclide method. The most common and informative type of bone examination.
• Ultrasound of the hip joint.
• Densitometry. Necessary to determine bone density and strength.

If the patient cannot sit or stand and there is no point in relieving the pain, he is immediately sent to the hospital for further surgical treatment.

When to see a doctor urgently

• When there is severe pain when moving in the hip joint.
• If it is impossible to support the affected leg.
• Detection of lumbar and femoral edema.
• 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 will lead to the development of complications.