Diseases that cause pain in the hip joint

Diseases of the musculoskeletal system in almost all cases are accompanied by dysfunction of its organs, which causes a lot of discomfort to the patient.

An important symptom of musculoskeletal pathology is pain. Joint injuries are especially unpleasant.

Cook is the biggest of them. The pain in case of its defeat can be localized around him and given to various anatomical structures: the organs of the small pelvis, lower back or thighs.

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 neoplasms.

There are additional specific causes of arthralgia:

• Piriformis syndrome. Associated with her prolonged cramping.
• Femoral head necrosis (GBC). It is most often a complication of another TBS pathology.
• Legg-Calve-Perthes disease. She has GBC osteochondropathy.
• Osteochondrosis dissection. In various sources it can be called Koenig's disease.
• Diabetic osteoarthropathy. Complication of diabetes.
• Pseudogout. Also chondrocalcinosis.
• Intermittent hydrosis is excessive production of synovial fluid.
• Synovial chondromatosis (Lotsch syndrome).

Also, the leg in the hip joint in pregnant women often hurts.

During this period, complex hormonal changes occur, the growing uterus moves adjacent organs and strains the ligament apparatus of the hip joint. In addition, weight gain increases the load on the legs. If the recommendations in the diet are not followed, the 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, the symptoms of TBS disease (hip joint) occur with a frequency of not more than 10%, and in the elderly - from 50%. Mostly women suffer from this pathology. This is due to hormonal changes associated with the years after menopause.

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

The main factors that cause arthralgia in the hip joint:

1. Pathological process within the musculoskeletal system. Most often it is due to direct mechanical action: bruising 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 MT (small pelvis) organs 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 fertilization of the musculoskeletal joint.

Inflammation of the hip joint is classified into:

1. Primarily. It is caused by the direct penetration of the pathogen into the joint: by hitting it with a sharp or blunt object, creating a wound.
2. Secondary. TBS infection arises from a distant focus of inflammation: contact or hematogenous route.

Arthritis TBS

It mainly occurs in elderly patients.Painful pain in the hip joint, intensified by walking, radiating to the groin, perineum and thigh. It is difficult for the patient to get up from the chair or climb the stairs without help. The discomfort worsens 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 the dysfunction of the immune system. It is characterized by polyarthralgia, stiffness in the morning, high fever is possible.

Shoulder and hip joints are extremely rarely affected, pain occurs only in the late phase of RA after a few years from the onset of the disease.

Acute septic arthritis

This is a contagious childhood disease, 70% of cases occur in babies under 4 years of age. The causative agent is usually Staphylococcus aureus. The child refuses to walk due to severe acute pain in the hip joint and groin when moving. It is characterized by high temperature and increased irritability.

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

The risk of developing osteomyelitis and sepsis is high.

Tuberculous cocciditis or arthritis

Pediatricians most often face this disease. In young children, the immune system is poorly developed, which leads to the possibility of infection.

This disease is characterized by slow progression. In the beginning, the child gets tired very quickly, his activity decreases, he stops running. Gradually, thigh muscle atrophy occurs. The movements are difficult. Pain in the hip joint in a child takes on an intense painful character, the limb becomes longer than healthy.

If the pus dissolves the synovial membrane, then 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 hip joint

This pathology is an inflammation of the tendons of the muscle and his vagina. Caused by prolonged overuse or leg injury.

Main complaints: femoral joint pain when moving, the lesion swells, change in gait - lameness becomes noticeable.

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

Bursitis

Of all the synovial sacs, the acetabulum burns are the most commonly inflamed.It partially covers the femur. In hip bursitis, the pain spreads to the thigh and gluteal region. The patient cannot lie on the affected side: the pressure in the synovial sac increases, and the pain intensifies.

If there are no complications with bursitis, then the treatment consists in relieving the lower extremity with a stick or crutch.

Medications: painkillers 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 discover such a problem, contact a specialist immediately to appoint the correct treatment.

The etiology is not completely clear. Modern medicine suggests that the leading cause is hereditary predisposition. People under the age of 30 are most often affected.

Symptoms of idiopathic ankylosing spondylitis:

• Fever, fever.
• Intoxication syndrome: general weakness, weakness, lack of appetite, weight loss, sleep disturbance.
• Constant dull pain in the hip joint, as well as at the level of 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 spreads to the covered parts of the spine along the entire back, including the neck. As a result, the patient assumes a forced "beggar's pose. "

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

Medications: NSAIDs to relieve pain and inflammation, corticosteroids.

Tendinitis

Athletes or people whose work is associated with hard physical work are prone to tendonitis. Feature of the manifestation: painful 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 treatment: NSAIDs, topical analgesic gels, glucocorticosteroids, chondroprotectors.

syphilis

In the late phase of the disease, bones and joints are affected. Tire formation is characteristic. Their excessive pathological mineralization occurs. TBS is extremely rare.

Rubber - a nodule in the tissues, formed during advanced syphilis, destroys the surrounding tissues. The process ends with the creation 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 long-term use of antibiotics and in pathologies of the immune system.

People who are infected with HIV or have AIDS are especially susceptible to fungal arthritis.

Joint pain is present constantly, of a painful nature.

Fungal bone lesions are characterized by a tendency to form fistulas, duration and difficulty of treatment.

Therapy: systemic antifungals.

According to the indications, surgery is being performed.

Bone and soft tissue tumors

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

1. Benign tumors of bone tissue - osteomas.

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

2. Malignant bone tumors - osteosarcomas.

   The neoplasm rapidly increases in size, necrotizes and disintegrates, spreading metastases throughout the body.The pain in the hip joints at night is unbearable, it does not stop even after taking NSAIDs or trying anesthesia.

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

Degenerative joint diseases

Coxarthrosis

Hip osteoarthritis is a chronic disease characterized by changes in the integrity of joint surfaces, due to violations of metabolic processes. It developed very slowly, over several years. Initially, cartilage tissue is affected, then bone tissue, followed by varus deformity of the joints and extremities. It occurs at the age of 40 years.

Symptoms:

• The hip joint only hurts when walking.
• Stiffness of movement in TBS.
• As the process progresses, the length of the limb shortens.
• Weakness and atrophy of muscle mass.
• Lameness.
• A creaking sound is heard while walking.
• In bilateral lesions, there is a "duck walk" - a transition from one leg to the other.

Drugs: NSAIDs, vasodilators, muscle relaxants, chondroprotectors, injections of hormonal drugs into the joint cavity.

Local effects: ointments, lotions, compresses.

In the last phase of the disease, surgery is underway.

Osteochondrosis

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

Symptoms:

• Pain in the lower back radiating to the hip and thigh joint.
• It is abrupt, sharp and sharp. It starts in the lumbar region and buttocks, descends down the back of the leg.
• Unilateral localization of pain is more common.
• The patient takes a forced position - lying on the healthy side.
• Probably reduced sensitivity of the skin of the feet.

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

Anesthetic block is recommended for severe pain.

Injuries

Injury

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

At rest, the symptoms disappear.

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

hip dislocation

Maybe:

• Congenital. It is the result of a failed birth or a pathology of intrauterine development. The child has uneven gluteal folds and shortening of the extremities, possibly pinched nerve, which is manifested by convulsions. If the dislocation is not corrected in childhood, the child may later become disabled.
• Traumatic. Signs: sharp severe pain, complete exclusion of joint function, massive edema and extensive hematoma appear above the damaged area. Getting up from a chair or bed for a patient becomes impossible without help.

In case of hip dislocation, you should immediately go to the emergency room or hospital.

fractures

Strong strong bones form the hip joint.

The most common diagnosis from this subgroup is a fracture of the surgical neck of the femur. It is mostly given to women after the age of 60.

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

The strongest pain is felt, the hip joint pulls and an abscess occurs, movement in it is almost impossible. The upper part of the 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, the inflammatory process can begin here. If the nerve is pinched, you may feel numbness in the thigh.

Treatment is complex: surgical and medical.

Specific causes of arthralgia

Piriformis syndrome

The localization of pathological processes in the area of the hip joint also affects the surrounding tissues. Prolonged spasmodic muscle piriformis compresses the sciatic nerve and its vessels, causing a number of symptoms:

• Leg pain in the hip joint. It goes to the buttocks and lumbosacral joint.
• Increased discomfort when leaning on the affected leg.
• Piriformis muscle contraction.
• Sudden lumbago pain along the nerve.

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

Medications: NSAIDs, muscle relaxants, analgesics, blood circulation enhancers, glucocorticoids.

After calming down the 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 thigh ischemia. With insufficient blood supply to the tissues, their oxygen starvation occurs and their necrosis (necrosis) begins.

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

Treatment is surgery and drug therapy.

Koenig's disease

Dissection osteochondritis - peeling of a small necrotized cartilaginous area from the bone and its protrusion into the joint cavity.

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

Patients complain of mild pain in the hip joint. The wrist "sticks" when moving.

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

Diabetic osteoarthropathy

Violation of glucose metabolism leads to disorders of circulation and innervation of all organs. Changes in the hip joint are more often unilateral: on the right side they occur more often than on the left side. The immune response is reduced, which makes it easier for the body to become infected.

Clinical picture:

• Swelling of the wrist.
• The skin over it is cold to the touch.

There is no pain syndrome in diabetic osteoarthropathy!

Treatment consists of careful monitoring of blood glucose 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:

• It begins with acute pain in the hip joint.

  Several types of calcium salts are known. Some of them (pyrophosphates) have 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. The acute attack is stopped by intra-articular administration of corticosteroids and NSAIDs.

Intermittent hydrosis

This is a chronic disease that manifests itself in attacks of increased production of synovial fluid. prone to frequent relapses.

It is diagnosed mainly in women aged 20-40.

The etiology is unknown. There are two theories about the origin of this disease: related to injuries and caused by endocrine disorders.

The joint increases in size, it becomes stiff.

The attacks go away on their own in 3-5 days.

Medical treatment is ineffective. Relapses occur even after surgery.

Synovial chondromatosis

This benign metaplastic disease is a replacement of synovial collagen by cartilage. The structure of the joint surface changes, as do its properties.

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

The etiology is unclear.

There is local swelling, limited joint function, creaking during its operation, arthralgia.

Treatment is only surgical.

Hip pain in children and adolescents

epiphyseolysis

This pathology is most typical for children during puberty (from 11 to 16 years). At this point, there is a sharp jump in growth. Due to the weak growth zone, HBA slides on the neck, resulting in discomfort in the hip joint.

The child feels pain in the thigh, which passes into the groin and knee. Lameness is noticed, but reliance on the limb is maintained.

The disorder is corrected surgically. You should start therapy as soon as possible. Otherwise, slipping HBA can cause the development of osteoarthritis and inflammation of the joints.

Dysplasia

It is the excessive creation of connective tissue that can replace bone elements. As a result, solid anatomical structures become plastic, flexible. Ligaments, menisci and tendons become weak. An unstable hip is formed, which is characterized by frequent dislocations.

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

The latent form can appear in adolescence.

If you notice manifestations of a wedge-shaped foot or foot deformity in a child, then you must quickly go to the hospital for an examination of the baby's musculoskeletal system!

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

Osteochondropathy

This group of diseases includes lesions of bone and cartilage tissue, in which the most stressed areas are subject to aseptic necrosis.

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

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

An adult should initially determine the location 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 HBC necrosis in children under 15 years of age. The right hip joint is more often 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 femoral head hurts. As the necrosis progresses, the arthralgia abruptly disappears. This indicates the death of sensitive organic receptors.
• Change in gait - the child begins to limp.
• Movement in TBS is limited.
• Mostly one-sided.

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

Diagnostic measures

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

In the case of hip disease, the following studies are necessary:

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

If the patient cannot sit or stand and the pain is not usable, he is immediately sent to the hospital for further surgical treatment.

When to see a doctor urgently

• When there is sharp pain when moving in the hip joint.
• If it is impossible to support the affected leg.
• Detection of lumbar and femoral region edema.
• Redness or bruising on the affected area.

There are folk ways to relieve pain in the pelvic joint. Relying on these tips for quick healing is not 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.