Hip arthritis: symptoms and treatment

Hip arthritis: symptoms and treatment

Category: Joints, bones, muscles 16004

• Redness of the skin
• Sweating
• Fever
• Pain in the groin
• Cyanosis of the skin
• Swelling of the affected joint
• Lameness
• Increased temperature in the affected area
• Pain in the affected joint
• Restriction of joint mobility
• Stiffness in the joints in the mornings
• Puffiness of the joint

Arthritis of the hip joint is a pathological process, which is characterized by the appearance of inflammation in one of the largest joints in a man - in the hip.

In most cases, it is accompanied by severe pain in the lesion.

If you miss the first symptoms of arthritis and start ailment, it will lead to deformation in the joint of certain joints and complete immobilization of the person.

The medical term "arthritis" means "inflammation of the joint". The disease has a progressive nature - the patient's condition without proper treatment will worsen and in the inflamed joint there will be irreversible changes.

In this case, inflammation in the joint arises from the infection that has penetrated the human body.

More often arthritis of the hip joint develops in the elderly, but recently the pathology has "grown younger." Now this diagnosis is put to people from 18 to 45 years and children.

Kinds

• rheumatoid arthritis.As a rule, the inflammation covers several joints at once. Its distinctive feature - joints are affected in most clinical cases symmetrically;
• reactive arthritis.It hurts the hip joint in rare cases. It occurs because of the transferred infectious ailments. Its danger is that it can affect not only the articulation, but also the surrounding shells, tissues and cartilage. Reactive arthritis is very difficult to treat;
• ankylosing spondylitis.Disease, which affects not only the hip joint, but also spreads to some parts of the spine;
• suppurative arthritis;
• gouty arthritis;
• psoriatic arthritis.

By the duration of the course of the disease, arthritis of the hip joint is divided into:

• acute.Symptoms of the disease manifested primarily. The duration of the manifestation of the disease is 8 weeks;
• protracted- less than one year;
• chronic.Symptoms of the disease in a person manifest more than one year;
• recurrent.

Causes

• the human body was infected with meningococcal infection, brucellosis and other diseases (this is the main reason for the development of reactive arthritis);
• bowel diseases;
• injuries;
• systemic diseases;
• gene mutations;
• dysplasia of the hip joints;
• genetic predisposition;
• persistent physical. load on the lower limbs.

Symptomatology

Symptoms of arthritis of the hip joint may differ slightly, depending on the underlying cause, which triggered its development. But there are signs that are common:

• There is a lot of pain in the groin. The pain intensifies during rest. Therefore, she practically does not bother the person in the daytime, when he is actively engaged in his work, walks, goes in for sports and so on;
• lameness. As a rule, it arises quite unexpectedly. This symptom is indicative of muscle atrophy. In medicine, there is a notion that is characteristic precisely for this feature - Trendelenburg's gait. The man's pelvis sinks to the side of his healthy leg, at a time when he starts moving. The reason is weakness of gluteal muscles;
• range of motion is limited. Most often, a person begins to experience some difficulties in making a turn of the foot;
• a sharp pain. As a rule, it occurs when you try to sharply kick your leg.

Changes in arthritis of the hip joint

Symptomatic, depending on the type of disease:

• rheumatoid arthritis. The patient notes that in the morning he has stiffness in the joint, as well as swelling and pain in the lesion. Joints, as a rule, are affected symmetrically. The danger is that this type of arthritis can also significantly damage the internal organs of a person;
• psoriatic arthritis. A characteristic symptom is that the skin turns blue. Often, the lesion extends to the vertebral parts;
• purulent arthritis. Sweating rises, then fever is added. Pain in the affected joint becomes stronger, especially when trying to make movements. The joint swells and becomes reddish purple;
• gouty arthritis. Mobility in the joint is disrupted almost immediately. Further, other symptoms also join in - redness of the affected tissues, their swelling. They become very hot to the touch. The pain is very severe and can last up to 10 days.

Treatment

Treatment of arthritis of the hip joint should only be complex. It includes surgical and innovative orthopedic techniques, the reception of necessary synthetic medical preparations.

Medication:

• nonsteroidal anti-inflammatory drugs. Helps reduce puffiness in the lesion, eliminate severe pain and reduce the permeability of the vascular walls;
• painkillers. As a rule, doctors prescribe them for external use;
• muscle relaxants. Needed to relax the musculature at the site of localization of arthritis;
• if arthritis was caused by an infectious disease (reactive arthritis or purulent), then it is indicated to take antibiotics to eliminate the primary source of the disease.

Surgical intervention is indicated only if the medication did not have the desired effect.

• arthroscopic synovectomy. In this operation, a certain part of the synovium is removed;
• hip joint prosthetics;
• cartilage transplantation. This is a new technique for treating arthritis. With a healthy cartilage surgeons take some of the tissue and in the laboratory grow it to the correct size, then again transplant it to a person;
• installation of a special metal spacer, which will simulate the surface of the joint.

Prosthesis of the hip joint

Arthritis in children

Arthritis of the hip joint in children is most often due to trauma, malfunction of the immune system, as well as infectious diseases.

The disease proceeds in acute form and can affect not only large and small joints, but also vision. Treatment should be carried out as soon as possible.

Disease in children has the same first symptoms as in adults. The child behaves restlessly, refuses to participate in active games, walk a long time and so on. This is the first thing that parents should pay attention to.

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If these signs are present, it is recommended to visit a doctor immediately for diagnostic purposes - ultrasound of joints, radiography and so on.

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The earlier a pathological process is revealed, the more simply it can be eliminated, and there will be no complications.

Treatment of arthritis of the hip joint in children is carried out exactly the same as in adults. Preference is given to drug therapy and physiotherapy.

Prevention

• a flexible way of life;
• correctly nutrition enriched with vitamins and minerals;
• gymnastic exercises;
• rejection of bad habits;
• reducing the load on the legs.

Diseases with similar symptoms:

Infectious arthritis (coinciding symptoms: 6 of 12)

Infectious arthritis (septic, pyogenic) is a serious infectious and inflammatory lesion of the joints, which leads to their gradual destruction.

It occurs in people of any age, but most often they are sick children and people aged after 60 years.

Modern medicine offers many treatments for this disease, but in spite of their diversity and effectiveness, every third patient, the infection causes irreversible violations in the joints, which lead to a complete loss of all of them functions.

... Psoriatic arthritis (coinciding symptoms: 6 of 12)

Autoimmune diseases of joints that occur on the basis of skin lesions are called psoriatic arthritis.

Psoriatic arthritis occurs on an equal footing with both men and women in adulthood.

... Reactive arthritis (coinciding symptoms: 6 of 12)

The disease, which is characterized by inflammation of the joints due to infectious diseases of various organs and systems, is called reactive arthritis.

Often, inflammation of the joints occurs due to infection with infections of the genitals, urinary system or even GIT.

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After infection of the body with infections in the second or fourth week, development of reactive arthritis can occur.

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... Bursitis of the elbow joint (coinciding symptoms: 6 of 12)

Bursitis is an inflammatory process in the joint bag (bursa). Affects the disease of any of the joints, and one of the most frequent is the bursitis of the elbow joint.

It has a characteristic course: the symptoms manifest gradually, which prevents timely diagnosis, and eventually leads to loss of ability to work, which is caused by the peculiarities of the structure of the joint.

According to ICD-10, the disease is denoted by the code M70.3.

... Arthritis of the knee joint (coinciding symptoms: 5 of 12)

Inflammatory process, manifested in the form of pain symptoms of the musculoskeletal system and affecting predominantly knee joints, is called arthritis of the knee joint.

In this case, it is very difficult for a person not only to walk, but also to perform flexion and extension of legs.

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Symptoms and Treatment of Hip Arthritis

Arthritis of the hip joint: symptoms and treatment - this question puzzles doctors in many countries, tk. is characterized by a high prevalence of the disease and the seriousness of its consequences.

Pathology is dangerous because it can develop at any age, even in young children.

Only timely detection and treatment at an early stage can preserve the full mobility of the joint.

Picture 1. Comparison of healthy and arthritic joints

The essence of pathology

Arthritis is a lesion of an inflammatory joint caused by an infectious allergic lesion and an autoimmune type malfunction.

This pathology should not be confused with another articular disease - arthrosis.

He, although manifested in many ways similar symptoms, but has a degenerative - dystrophic nature.

Arthritis, affecting the hip joint (coxit), is a fairly common form of the disease, developing at the junction of the pelvic cavity of the pelvic and femoral head. The photo illustrates such a defeat of the joint. (Photo 1. Comparison of healthy and affected joints).

The development of arthritis begins with damage to the synovial articular membrane (more often of an infectious nature), which leads to the launch of an immune reaction to the production of antibodies.

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They, as a result of failures in the work of the system, form immune complexes leading to a number of cytotoxic processes and an inflammatory reaction.

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It gradually spreads to the cartilaginous and periarticular tissues.

Thus, arthritis at the initial stage manifests itself in the form of an acute sinusovitis with a predominance of exudative changes. Further, fibrotic sclerotic disorders develop in the cartilaginous lining and surrounding tissues.

The proliferating connective tissue gradually destroys the cartilage and bony epiphyses with the formation of erosions, cracks and cracks. The synovial fluid changes its composition and becomes turbid.

In the advanced stage the cartilage is completely destroyed, which leads to deformation and immobilization of the joint.

Varieties of pathology

Depending on the etiological mechanism and the nature of the disease, the following main types of hip arthritis are distinguished:

1. Rheumatoid arthritis of the hip joint. It is also called infectious-allergic deforming polyarthritis. This species is considered the most common and dangerous form. This arthritis refers to diseases of a systemic nature and, in addition to joints, affects other internal organs.
2. Reactive type. This variant arises as a result of a malfunction of the immune system after the transferred or during the infectious disease. Antibodies to infection antigens mistakenly attack articular cells, taking them for an alien body.
3. Gouty shape. The disease is caused by an inflammatory reaction, provoked by the accumulation of urates. The main symptom is an intense pain syndrome, which can last several days.
4. Tubercular type. This type of pathology develops more slowly than other forms, because joints are affected only after the lungs, kidneys and other organs are affected.
5. Septic arthritis. It belongs to purulent types, and therefore presents an increased danger, especially for children. In the joint cavity accumulates purulent exudate, which can cause severe general intoxication.
6. Psoriatic appearance. The disease develops against the background of the underlying disease (psoriasis) and is characterized by a bright pigmentation of the skin over the affected joint.

Etiological phenomena

The etiological mechanism of arthritis has not been fully understood to the present, but certain patterns of the origin of the disease have been studied in detail. In general, there are two directions of the causes leading to this pathology:

• infectious disease;
• an endogenous factor of an autoimmune or allergic nature.

Infectious damage is caused by the following pathogenic microorganisms on the body:

• intestinal infection (salmonellosis, shigellosis, yersiniosis);
• infection of the urogenital tract (chlamydia, mycoplasma, ureaplasma);
• streptococcus groups A and B (cause rheumatoid arthritis).

In this case, the infection rarely penetrates into the joint itself, but enough damage to the body, and then turns on the autoimmune mechanism. Quite often, such diseases as meningitis, Lyme disease, tuberculosis, brucellosis, rubella, gonorrhea become the cause.

Inflammation in the joint can occur without infection.

Allergic reactions, metabolic disorders, hereditary diseases with immune system damage, Bekhterev's and Crohn's diseases, malignant formations are allocated in this direction. Provocators of the inclusion of the etiological mechanism are such factors:

• hereditary predisposition;
• frequent and prolonged physical overload of the joint;
• trauma in the hip region;
• supercooling;
• diseases of the musculoskeletal system;
• hormonal disorders;
• taking some medications.

Symptomatic manifestations

Symptoms of arthritis of the hip joint depend on the type of pathology, but generally have common features. There are several categories of symptoms:

• manifestation of the inflammatory reaction: pain syndrome, swelling, redness, increased temperature in the affected joint zone;
• signs of structural disorders: limitation of mobility, up to complete immobilization; stiffness; deformation of the joint; lameness;
• signs of general intoxication of the body: febrile state, general weakness, fatigue, headache, loss of appetite.

Coke can develop in acute, subacute and chronic form. Depending on this, the intensity of manifestation of symptoms also changes. Acute and subacute stages of the disease are marked by a sharp, unexpected manifestation of pain, swelling, blocking movement.

The general condition of the patient is significantly deteriorating. The untreated acute form passes into a chronic course. This development of pathology is characterized by alternating phases of exacerbation and complete remission.

There is a slow destruction of the joint tissues, which can lead to loss of mobility of the joint.

The intensity of pain depends on the type of lesion and its severity. As the pain syndrome progresses, it becomes the main factor limiting mobility.

At the initial stage, the limitation of movements is associated with pain due to increased muscle tone, and then - with violations in the joint capsule.

The pain syndrome is directly related to mechanical stress. The most severe pains appear in the morning, immediately after lifting, as well as after a long stay in a sitting position. After a short walk they cease.

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In general, the manifestation of pain syndrome increases with the progression of the disease.

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If at the initial stage it has the appearance of this "starting pain" or appears only under physical stress and disappears after rest, in the started stage the pains are fixed and at rest they can continue in an intensive mode up to 2 - 3 days.

It is pain that gradually leads to a change in gait. A sick person instinctively looks for support so that discomfort is minimal, which gradually becomes a habit.

It is typical for the pathology of the so-called Trendelenburg's gait, when the pelvis is lowered in the direction of the foot, opposite the focal point of the lesion. At the last stages of coxitis, there are pronounced signs of joint deformity.

Stable contractures are formed, shortening of the lower limb is observed.

Principles of treatment of the disease

Treatment of arthritis of the hip joint is usually of a conservative nature, but in the presence of an acute purulent process in the advanced stage, surgical intervention is performed. The basis of treatment is:

• drug therapy;
• physiotherapy;
• physiotherapy;
• massage;
• special orthopedic techniques.

When arthritis of the hip arises, treatment with drugs solves the following problems:

• destruction of infection (with infectious etiology);
• elimination of the inflammatory process;
• symptomatic therapy (anesthesia);
• normalization of the immune system;
• general strengthening of the body.

In order to treat arthritis with intense pain syndrome and marked signs of inflammation reactions, non-steroidal anti-inflammatory drugs are prescribed: Orthofen, Nurofen, Nyz, Xefokam. In childhood, the most common application of Ibuprofen and Nemesulide. In severe cases, glucocorticoids are administered: Hydrocortisone, Dexamethasone, Prednisolone.

In the specialized medical centers the complex treatment of the disease with the use of such technologies is widely used:

1. Use of the DRX apparatus, which provides stretching of the affected joint.
2. Percutaneous neural stimulation with pulses of low frequency current, which allows to stop pain, improve blood supply, eliminate swelling and muscle spasms.
3. Laser treatment, which has anti-inflammatory and stimulating ability.
4. The introduction of the Alloplant special substance, which gradually dissolves and stimulates the normal functioning of the immune system.
5. Reflexotherapy based on acupuncture.
6. Electrophoresis with the introduction of drugs.
7. Application of the device Amplipulse for low-frequency impact on the lesion.
8. High-frequency impulse with the help of the apparatus Darsonval.
9. Ultrasonic therapy.
10. Therapeutic acupressure.
11. Magnetotherapy. The impact on the affected joint of the magnetic field improves metabolic processes, relieves pain and swelling.

Arthritis of the hip joint is a painful and dangerous pathology, which must be detected and treated in a timely manner at the earliest stages.

The triggered disease can lead to complete immobilization of the joint. Particular attention should be paid to the development of children's hip arthritis, tk.

his purulent form can lead to tragic consequences.

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Arthritis of the hip joint

Arthritis of the hip joint- is an inflammatory process in the connective tissue of the surface of the femoral joint and pelvic girdle. Modern medicine distinguishes several names of this inflammation.

The formation of the disease is provoked by more than two hundred infections, including tuberculosis, gout, rheumatism, etc.

The purpose of treatment for arthritis is based on the causes that gave rise to it.

Very often physicians use non-steroidal anti-inflammatory drugs, for example, Aspirin or Indomethacin (a total of more than 45 different drugs).

Often, the disease develops in people who have reached 40-45 years of age. According to statistics, women are predisposed to the disease more often than men.

Victim can become either one or both hip joints.

However, even in the case of the emergence of a bilateral focal infection, the disease will attack first on one joint, and then go to the second.

What causes it?

For a long time it was believed that arthritis of the hip bone and pelvic girdle is a consequence of the destructive effect of infectious microorganisms. However, studies have shown that such a development scenario is inherent only in certain types of arthritis, for example, syphilitic or tubercular.

In these cases, dangerous microorganisms live right in the joint fluid. The true reason is overwhelmingly hidden in a slightly different direction.

Long-term studies of the causes and effects of arthritis of the hip joint have opened to scientists a special significance of the genetic factor. Experiments and observations were conducted, which proved the possibility of the onset of the disease from generation to generation.

This is because any person inherits from parents a set of specific qualities and properties organism, which either manifest from the moment of birth, or does not reveal itself in any way during the whole life.

The development and course of diseases listed above areas of the body can progress through the influence of autoimmune reactions.

The essence of this phenomenon is that it represents a certain type of allergic reaction, when the organism in accelerated rate generates antibodies, mistakenly taking its own cells of organs and tissues for harmful antigens.

Such a malfunction of the organism leads to damage and death of components whose cells have been attacked with antibodies.

Symptoms of the disease

In order to understand the symptoms of arthritis, several types of disease should be considered. Traditionally and somewhat conditionally five of these groups. It is worth noting that the symptoms can be similar for different species, and absolutely unique.

Infectious arthritiship joint in 75% of cases occurs, almost without showing any symptoms. Episodically, the patient shows signs of fever with concomitant headache, can attack cough, skin can cover with a rash.

Cartilage damage was noted in 15% of cases. In children, osteoarthritis often occurs against a background of digestive system disorders, pain in the intestines, nausea and vomiting.

In adult patients with pyogenic arthritis, rashes on the skin occur rarely, but joints become inflamed in 60-70% of cases.

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The development of rheumatoid arthritis in most episodes is preceded by all sorts of infectious diseases - colds, tonsillitis, acute respiratory infections, influenza. The disease manifests itself in the defeat of the hip joint surfaces against the background of chronic connective tissue disease.

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Note some specific signs. Lasting pulsating pains in the joints, usually worse in the morning and stopping by the evening. Some stiffness and discomfort during movement is felt by patients who developed the disease on the pelvis.

Reactive arthritisoccurs in parallel with the infectious process. This type of joint disease has an immunoinflammatory character. The risk zone includes young people from 18 to 40 years.

Men among patients in this form of arthritis are much more than women. The onset of symptoms is notable for its rapidity, inflammation affects not only the joints, but also tendons, nails and skin, lymph nodes that increase in size.

Infection can affect the mucous membranes, kidneys, as well as the cardiovascular system.

Arthrosis Arthritiship joints develops in those cases when inflammatory processes lead to pathological changes in bones and joints.

Because of the fidgety pathology, lameness, "slowness" of the hip, limitation of the mobility range of the joint.

Acute arthritiship joint is characterized by severe pain in the affected joints, which occurs sharply and periodically.

The area of ​​the joint swells, the temperature rises. Rare eruptions of cyanotic and burgundy shades are possible.

The general condition of the body worsens due to the appearance of fevers, chills, migraines, insomnia.

How to treat arthritis of the hip joint?

Description of conservative methods

The conservative methods are used mainly at the early stages of the development of the disease, during the period of remission and recovery.

Methods can be divided into the following groups:

• Medication
• Physiotherapeutic procedures

At the initial stage of the disease, it is necessary to stop the main symptom - severe acute pain. Therefore, the first actions of the doctor are directed to the removal of the pain syndrome and the inflammatory process.

The basic instrument of drug therapy for hip arthritis, especially with acute and infectious form, is the use of nonsteroidal anti-inflammatory drugs. They very effectively cope with swelling and inflammation, contribute to reducing pain.

However, do not forget that non-steroid drugs bring only temporary relief, reducing the progress of infectious inflammation, but they do not treat arthritis themselves.

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In some cases, when pain occurs as a result of muscle spasms, the patient prescribes muscle relaxants. They fight with spasms and help improve blood flow.

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Treatment of reactive arthritis is to eliminate the focus of inflammation. The patient is given a course of antibiotics, which he will take along with anti-inflammatory drugs. the incapacity of the patient in this case is extended by one and half two months.

Therapeutic measures in rheumatoid arthritis are associated with the cure of organs that have been damaged by the infection.

Used drugs, whose action is aimed at reducing the inflammatory process.

After the course of therapy, the mobility of the affected joint is restored.

The most useful group in the treatment of arthritis are chondroprotectors.

It is advisable to use chondroprotectors at the beginning of the course of the disease. However, their importance is not overestimated.

The use of drugs in later stages is meaningless - the joint by this time will be virtually destroyed.

The maximum result is achieved after passing a minimum of two courses of treatment. The intake of drugs, thus, will last for up to a year and a half.

Physiotherapywith arthritis is mainly used for postoperative recovery. Often used magnetotherapy, ultrasound treatment, the use of lasers and light.

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Physiotherapy is often carried out in parallel with the application of creams and ointments. The main goal of physiotherapy is to improve blood flow and alleviate muscle spasms.

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On the course of the disease, there is no special influence.

MassageIt is especially effective for arthrosis-arthritis of the hip joint. The result will be improved circulation, removal of pain, swelling of the muscles. Massage can be done manually or with the use of special massage aids.

Operative intervention

In modern medicine, as a surgical method, they prefer to use endoprosthetics. It consists in the complete replacement of the hip joint, which has undergone deformation, with an artificial analogue.

Especially often the prosthesis is used for arthrosis-arthritis, when a pathological change in the pelvic bones occurred.

The signal for a second operation will be returned painful pain and discomfort when walking.

Folk remedies

Traditional medicine has in its arsenal enough funds for the treatment of arthritis, especially in the initial stage.

For example, the preparation of broth from the leaves of cranberries. Boiled and strained drink to consume during the day. This will help alleviate arthritic pain.

Berezovye and Conifer baths are well proven.

For their preparation, kg of birch leaves are wrapped in cotton cloth and boiled in water for half an hour. The resulting water and the tissue itself filled in a bath. The course is held daily for a month. Birch leaves can be replaced with coniferous needles.

For treatment the recipe of the ancient Ural ointment will suit.

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Mix salt and dry mustard in the proportions:. After the addition of paraffin, the mass will turn out, in some ways reminiscent of the cream. We need to give it a night's rest, and it will be ready for use.

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The area of ​​the affected joint should be rubbed before going to bed until the ointment is completely absorbed into the skin. Next morning, wash the place with warm water.

If there are swelling, then to reduce their volume, the area treated with ointment should be bandaged and insulated.

It is also necessary to resort to treatment with various herbs, for example, elder, nettle, cherry fruit, etc. It will be useful to apply alcohol tinctures in combination with pepper, turpentine, fighter root or goose fat. Instead of alcohol you can use vodka tinctures.

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Arthritis of the hip joint

Arthritis of the hip joint- pathological inflammatory reactions, developing in the articular surfaces of the acetabulum and the head of the femur.

Patients with arthritis of the hip joint are concerned about pain in the groin, thigh or buttocks, stiffness and limitation of range of motion, difficulty walking, limping gait.

A variety of arthritis is established with the help of ultrasound, X-ray, MRI of the hip joints, diagnostic puncture, blood test.

The general therapeutic algorithm for arthritis of the hip joint includes immobilization, medication therapy, physical therapy, massage, physiotherapy; in case of inefficiency - optimal surgical treatment.

Hip arthritis (coxitis) is an inflammatory process of various etiologies in which connective tissue is involved in the area of ​​articulation of the pelvic and femur.

With arthritis, inflammation develops in the synovial membrane lining the joint cavity.

However, without timely and adequate treatment, the coke is rapidly transformed into osteoarthritis of the hip joint, at which there are degenerative-destructive changes of articular cartilage and subchondral bones.

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Chronic pain syndrome and hip dysfunction in arthritis not only limits the physical activity of patients, but can also cause the acquired disability.

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Since arthritis of the hip joint can be a part of joint syndromes of different etiologies, the true prevalence of the disease remains unknown. It is believed that the frequency of development of cocksite is second only to arthritis of the knee joint.

The hip joint is formed by the articulation of the bowl-shaped acetabulum of the pelvic bone and the head of the femur. By the type of connection, it refers to the globular joints.

The cavity of the acetabulum and the head of the femur are covered with hyaline cartilage. In the center of the articular cavity there is a zone of loose connective tissue serving as the attachment site of the ligament of the head of the femur.

The hip joint performs complex functions of support and movement (flexion and extension, withdrawal and reduction of the lower limb, rotation inside and out).

Classification of arthritis of the hip joints

The generally accepted classification of coke is not developed. In rheumatology, traumatology and orthopedics, arthritis of the hip joint is classified according to etiological and pathogenetic mechanisms, distinguishing the following types:

According to the clinical course arthritis of the hip joint can be acute (with a duration of the primary joint attack less than 2 months), prolonged (up to 1 year), chronic (longer than 1 year), relapsing (if there is a re-articular attack after a remission period of at least 6 months).

Coxites can be primary-bone or primary synovial.

Examples of primary synovial arthritis of the hip joint are rheumatoid and reactive arthritis.

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About the primary-bone arthritis speak in the case when the bone tissue is initially affected, and then - the synovial membrane (for example, with tuberculous arthritis).

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Purulent arthritis of the hip and other joints can be a complication of injuries, injuries, diagnostic puncture of the joint, operations that result in direct infection joint cavity.

In other cases, septic coxitis can develop when a purulent focus breaks out from neighboring tissues (with phlegmon, osteomyelitis, etc.)

) or metastatic infection of the joint cavity from distant inflammatory foci (with furunculosis, tonsillitis, otitis, pneumonia, etc.).

In addition to infectious arthritis caused by nonspecific pyogenic flora, there are specific coxites associated with tuberculosis, brucellosis, gonorrhea, syphilis.

Secondary aseptic arthritis of the hip joint can be associated with diseases such as psoriasis, systemic lupus erythematosus, Crohn's disease, ankylosing spondylitis, and others.

Reactive arthritis occurs after intestinal (salmonellosis, dysentery, yersiniosis) or urogenital infections (chlamydia, ureaplasmosis, mycoplasmosis) and also are aseptic.

Rheumatoid arthritis is characterized by a complex autoimmune mechanism of development; is more common in carriers of antigen HLA-DR1, DR4.

In the risk group for the development of arthritis are children with dysplasia of the hip joints, people with a weighed heredity, obesity, bad habits, traumatic hip dislocations, experiencing excessive physical load.

Symptoms of arthritis of the hip joint

The most frequent forms of arthritis of the hip joint, found in clinical practice, are tuberculous and acute purulent coxitum. The remaining forms are observed much less frequently.

With purulent coke, a rapid onset of the disease is noted with the predominance of symptoms of general intoxication: fever, weakness, sweating, loss of appetite, headache.

Significantly expressed local changes: the skin over the area of ​​the joint becomes tense, hyperemic and hot to the touch. There is a sharp pain (shooting, pulsating), which is even worse when moving.

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Due to inflammatory infiltration and the formation of purulent effusion in the joint cavity, the shape of the latter substantially changes.

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For other forms of arthritis of the hip joint is characterized by gradual development.

In the initial stages, dull, aching pains in the inguinal region, from the outside of the thigh, buttocks, prevail, which limit the volume of movements or make walking difficult.

Due to the stiffness of the hip joints, the movements become chained, uncertain, and the walk is limp (Trendelenburg's gait).

Most often, pain and stiffness in the hip arises after its long fixation in one posture in or uncomfortable position, for example, when sitting or standing for a long time. Over time, patients may develop atrophy of the femoral and inguinal muscles, fibrous or bone ankylosis.

In the outcome of a specific inflammation often develops a pathological dislocation of the hip, immobility of the hip joint, muscle atrophy and shortening of the limb.

In children, arthritis of the hip joint is more acute, with more pronounced local and general symptoms of inflammation.

Psoriatic coxites are accompanied by the appearance of a characteristic bluish-purple coloration of the skin over the inflamed joint, pains in the lower parts of the spine.

With rheumatoid arthritis, the hip joints are afflicted symmetrically.

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Progressive dystrophic changes in the joint with time lead to the development of secondary coxarthrosis.

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When conducting a survey of a patient with an inflammatory lesion of the hip joints, limited to the setting of a syndromic diagnosis; mandatory to determine the root cause of arthritis. To this end, the nature and intensity of pain, the duration of the course of the disease, the concomitant pathology are elucidated from the anamnesis. The examination of the patient is carried out in a prone position, while standing and while walking. Special attention is paid to the shape of the joints and the position of the limbs, the presence of muscle atrophy and contractures, gait, the ability to perform and the amplitude of passive and active movements.

Along with the clinical examination, the crucial role in the diagnosis of arthritis is played by the methods of radiation diagnosis: radiography of the hip joint, ultrasound, MRI, contrast arthrography, etc.

To assess the nature of inflammation, a diagnostic puncture of the hip joint is performed under ultrasound guidance.

With the help of laboratory methods (ELISA, determination of CRP and RF, investigation of synovial fluid), the origin of arthritis of the hip joint is specified. If tuberculous arthritis is suspected, phthisiatric consultation and tuberculin diagnostics are indicated.

Treatment of arthritis of the hip joint

Depending on the cause and stage of arthritis of the hip joint, its treatment can be carried out by a rheumatologist, a surgeon, traumatologist-orthopedist, phthisiatrist.

In the acute stage, a plaster cast is applied to ensure maximum unloading and resting of the hip joint.

Pharmacotherapy is carried out taking into account the aetiology of coke and may include the administration of NSAIDs, specific chemotherapy (for tuberculous arthritis), antibiotic therapy (with infectious arthritis), etc.

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According to the indications, intra-articular injections of corticosteroids are performed. With purulent coke, a series of therapeutic punctures is performed, lavage of the joint with antiseptic solutions, flowing joint drainage.

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After relief of acute manifestations of arthritis of the hip joint massage is prescribed, therapeutic gymnastics and swimming, physiotherapy (magnetotherapy, ultrasound, UHF, paraffin therapy, mud therapy and etc.). To facilitate movement, it is recommended to use walking sticks, crutches, walkers and other devices.

If the attempts of conservative therapy of arthritis are unsuccessful, in case of chronic pain and persistent restriction of joint function is solved the question of surgical intervention (synovectomy, total hip arthroplasty, arthroplasty, arthrodesis, arthrosis and other).

Prognosis and prevention of arthritis of the hip joint

The outcome of arthritis can be, as easy stiffness, and complete ankylosis of the hip joint. Complications of purulent arthritis can be an infectious-toxic shock or sepsis.

Timely and high-grade treatment allows minimizing the dysfunction of the hip joint, preventing the development of osteoarthritis.

In order to prevent arthritis, it is necessary to monitor weight, take seriously the treatment of any infections and associated diseases, and carry out PCO of penetrating joint wounds.

A source: http://www.krasotaimedicina.ru/diseases/rheumatology/hip-arthritis