Almost all diseases of the musculoskeletal system are accompanied by the dysfunction of their organs, which brings a lot of inconvenience to the patients.
An important symptom of lesions of the musculoskeletal framework is pain. Joint injuries are especially unpleasant.
The hips are the largest of them all. If it fails, pain can localize around it and transmit it to various anatomical structures: the small pelvis, the organs of the lower back, or the thighs.
General Classification of Causes
Hip pain can have a variety of causes.
Medically, the following causes of joint pain are conditionally distinguished:
- Inflammatory and infectious processes in joints and surrounding tissues.
- Degenerative diseases of the musculoskeletal system.
- Injuried.
- Bone and soft tissue tumors.
There are other specific causes of joint pain:
- piriformis syndrome. related to her prolonged spasms.
- Necrosis of the femoral head (GBC). In most cases, it is a complication of another TBS pathology.
- Legg-Calve-Perthes disease. She is osteochondrosis of GBC.
- Anatomy of osteochondrosis. In various sources, it may be called Koenig's disease.
- Diabetic Osteoarthropathy. Diabetic complications.
- pretend. And chondrocalcinosis.
- Intermittent hydrojoint is an excess production of synovial fluid.
- Synovial chondromatosis (Lotsch syndrome).
In addition, pregnant women often experience pain in their legs in the hip area.
During this time, complex hormonal changes occur, and the growing uterus displaces adjacent organs and strains the ligaments in the hip joint. Also, gaining weight can increase the load on the legs. If dietary recommendations are not followed, pregnant women may be deficient in calcium because the structure of bones and joints is disturbed due to an imbalance of this mineral.
cause of pain
The prevalence of joint pain increases with age.Symptoms of TBS disease (hip) occur less than 10% of the time in children and 50% of the elderly. Most women have this disorder. This is due to age-related hormonal changes after menopause.
Why does the hip joint hurt? There is no clear answer to this question because the list of reasons is long.
The main factors that cause hip joint pain:
- Pathological processes within muscle ligaments. In most cases, this is the result of direct mechanical action: bruising of the joint and subsequent inflammation of its components.
- Anatomical changes in joints. They can be congenital or posttraumatic (dislocations, fractures).
- Pathology of other systems. Inflammation of the MT (small pelvis) organs can spread to the pelvic bones. Neurological disorders manifest as pain of any location. Metabolic disorders can lead to mineral imbalances. The bone-ligamentous connections are weakened and the risk of injury increases.
Inflammatory and infectious processes in joints and surrounding tissues
The most common cause of joint pain of any location is musculoskeletal joint suppuration.
Hip arthritis is divided into:
- basic. It is formed by direct penetration of pathogens into joints: striking with a sharp or blunt object and creating a wound.
- Minor. TBS infection occurs from distant inflammatory foci: by contact or by the hematogenous route.
Arthritis TBS
Occurs mostly in elderly patients.Hip pain, aggravated by walking, radiating to groin, perineum, and thighs. The patient has difficulty getting up from a chair or climbing stairs without assistance. More uncomfortable in the morning.
Treatment consists of taking anti-inflammatory drugs and introducing glucocorticoids into the joint bursa. Empty its cavity if necessary.
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 immune system dysfunction. Characterized by polyarthralgia, stiffness with morning exercise, and possibly high fever.
The shoulder and hip joints are rarely affected, and pain only occurs in advanced RA years after the onset of the disease.
acute septic arthritis
It is a contagious childhood disease that occurs in 70% of cases in infants under the age of 4. The pathogen is usually Staphylococcus aureus. The child refuses to walk due to severe pain in the hip and groin when moving. Characterized by hyperthermia and increased excitability.
Treatment includes removal of joint fluid and antibiotic therapy.
There is a high risk of developing osteomyelitis and sepsis.
tuberculous arthritis or arthritis
Most of the time, pediatricians are faced with this disease. In young children, the immune system is underdeveloped, which leads to the possibility of infection.
The disease is characterized by slow progression. Initially, the child tires quickly, his activity decreases, and he stops running. Gradually, the thigh muscles atrophy. Movement is hindered. Hip pain in children has a strong pain profile and the limb becomes longer than healthy.
If the pus melts the synovium, the exudate spreads along the muscles and tendons, forming phlegm and fistulas.
In the absence of complications, conservative treatment is performed.
Tenosynovitis in the hip area
This pathology is inflammation of the muscle tendons and their vagina. Caused by prolonged overuse or leg injury.
Main complaints: pain in the hip joint when moving, swelling of the lesion, changes in gait - lameness becomes apparent.
Treatment-Medications: Anti-inflammatory drugs, intra-articular injections of corticosteroids.
Bursitis
Of all synovial bags, the acetabular sac is the most commonly inflamed.It partially covers the femur. With hip bursitis, the pain radiates to the thigh and buttock area. The patient cannot lie on the affected side: the pressure in the synovial sac increases and the pain increases.
If bursitis is uncomplicated, treatment consists of removing the lower extremity with crutches or crutches.
Medications: Pain relievers and corticosteroids.
idiopathic ankylosing spondylitis
This is a chronic inflammation of the spine and sacroiliac joint elements.
The disease is dangerous because its complications reduce living standards and lead to disability.
If you notice such a problem, you should contact a specialist immediately to book the correct treatment.
The cause is not fully understood. Modern medicine believes that the main reason is genetic predisposition. In most cases, people under the age of 30 get sick.
Symptoms of idiopathic ankylosing spondylitis:
- Elevated body temperature, fever.
- Toxic syndrome: general malaise, weakness, loss of appetite, weight loss, sleep disturbance.
- 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.
- Lower back and hip mobility is limited. The symptoms gradually spread to the overlying portion of the spine throughout the back, including the neck. As a result, the patient is forced to assume the "petitioner's pose".
Rehabilitation therapy is based on special physiotherapy exercises to promote joint development.
Medications: NSAIDs, corticosteroids for pain and inflammation relief.
tendonitis
Athletes or people who perform heavy physical labor are prone to tendon inflammation. Performance characteristics: hip pain, heavy load. At rest, discomfort is usually not observed.
It is recommended to reduce the load on the legs, in advanced cases - bed rest.
Drug therapy: NSAIDs, topical analgesic gels, glucocorticoids, chondroprotective agents.
syphilis
In the advanced stages of the disease, bones and joints are affected. The formation of chewing gum is characteristic. They undergo excessive pathological mineralization. TBS is extremely rare.
Gumma - a node in the tissue, formed during late syphilis, destroying surrounding tissue. The process ends with the formation of rough scars.
Treatment is ineffective and there is a high risk of complications from osteomyelitis.
Fungal arthritis of the hip
It is the result of prolonged antibiotic use and immune system lesions.
People with HIV or AIDS are particularly at risk of developing fungal arthritis.
Joint pain is constant and has the characteristics of soreness.
Fungal lesions of the bone are characterized by the tendency to fistula formation, the duration, and the difficulty of treatment.
Treatment: Systemic antifungal drugs.
Surgical intervention is performed according to the indications.
Bone and Soft Tissue Tumors
Neoplastic disease of the hip can be a metastases from distant organ cancers or arise independently.
- Benign tumors of bone tissue - osteoma.
Alien bodies grow, squeezing nerves and blood vessels. Clinically similar to piriformis syndrome.
- Malignant bone tumor - osteosarcoma.
The tumor rapidly increased in size, necrotic and disintegrated, and spread and metastasized throughout the body.Hip pain is unbearable at night and doesn't stop even after taking NSAIDs or trying anesthesia.
- Mesenchymal tumors are formed from soft tissue. Benign ones rarely recur and do not metastasize. The intensity of pain is variable depending on the aggressiveness of the malignant cells.
degenerative joint disease
hip disease
Hip osteoarthritis is a chronic disease characterized by changes in the integrity of the joint surface due to disruption of metabolic processes. It develops very slowly and takes several years. Initially, cartilage tissue is affected, followed by bone tissue, followed by varus deformities of joints and limbs. occurred at the age of 40.
symptom:
- The hip joint only hurts when you walk.
- Stiffness of motion in TBS.
- As the procedure progressed, a reduction in limb length was observed.
- Weakness and atrophy of muscle mass.
- lame.
- When walking, a crunching sound is heard.
- With bilateral lesions, there is a "duck gait" - shifting from one leg to the other.
Drugs: Non-steroidal anti-inflammatory drugs, vasodilators, muscle relaxants, chondroprotectants, hormonal drugs injected into the joint cavity.
Local effects: ointments, lotions, compresses.
In the final stages of the disease, surgery is underway.
osteochondrosis
Degenerative changes to the disc can cause damage to surrounding tissue.
symptom:
- Lower back pain radiating to the hips and thighs.
- It is sudden, sharp and sharp. It starts at the waist and hips and descends to the back of the legs.
- Unilateral localized pain is more common.
- The patient takes a forced position - lying on the healthy side.
- May reduce sensitivity of skin on legs.
Treatment is complicated. Anti-inflammatories and analgesics, moderate physical activity (swimming), physiotherapy after the most acute symptoms subside.
If there is significant pain, anesthesia blockade is recommended.
Injuried
Injuried
Moderate pain is characteristic and increases in intensity during active movement. The first limp after a hip injury passed quickly.
Symptoms disappear with rest.
To quickly relieve pain in the event of an injury to the pelvic joint, it is necessary to apply a cold compress to the injured area: ice packs or frozen products.
hip dislocation
perhaps:
- congenital. It is the result of an unsuccessful birth or abnormal intrauterine growth. The child's hip folds are uneven, and the limbs are shortened, which may be nerve compression, manifested as convulsions. If the dislocation is not corrected in infancy, the child may become disabled later on.
- traumatic. Signs: Severe, severe pain over the injured area, complete closure of joint function, massive edema, and extensive hematoma. Without assistance, it is impossible for a patient to get up from a chair or bed.
If a hip dislocation occurs, you should go to the emergency room or hospital immediately.
fracture
The hip joint is made up of strong bones.
The most common diagnosis in this subgroup was operative neck fracture of the femur. It is mainly aimed at women over the age of 60.
The cause of such damage is a drop or impact on the TBS area.
Feel the most intense pain, hip pull and abscess, almost impossible to move. The upper thigh is swollen and there is an extensive hematoma. The injured leg was shortened and the patient limped. As you move, you will hear a characteristic clicking sound.
When a fracture occurs, the surrounding tissue is damaged and accompanied by a burning sensation. In the absence of treatment, the inflammatory process can begin here. If the nerve is pinched, you may experience numbness in your thigh.
Treatment is complicated: surgery and drugs.
Specific causes of joint pain
piriformis syndrome
With the localization of the pathological process in the hip region, surrounding tissues are also affected. Long-term spastic piriformis compresses the sciatic nerve and its blood vessels, causing symptoms such as:
- Leg pain in the hip area. She went to the hip and lumbosacral joints.
- Increased discomfort when leaning on the affected leg.
- Tightening of the piriformis muscle.
- Sudden pain along the nerve "low back pain".
Causes: Pelvic organ damage, infectious and inflammatory disease, vertebral disease, muscle overtraining, prolonged non-physiological posture.
Drugs: NSAIDs, muscle relaxants, analgesics, blood circulation improvers, glucocorticoids.
After the acute phenomenon subsides, rehabilitation measures can be prescribed: physiotherapy, massage, acupuncture.
aseptic necrosis of the femoral head
The vast majority occur in young men. The cause of the disease is ischemia of the upper thigh. Because the tissues have insufficient blood supply, they become deprived of oxygen and begin to die (necrosis).
Clinical picture: Hip pain in the legs and perineum. It is impossible to rely on the injured leg. After a few days, the nerve endings melt and the pain goes away. This is a scary sign! There is a high risk of rapid development of osteomyelitis and sepsis with deeper necrosis of the bone.
Treatment is surgery and medication.
Koenig's disease
Dissecting osteochondritis - peeling a small area of necrotic cartilage from the bone and protruding it into the joint cavity.
This is a rare disease. For men 15-35 years old.
The patient complained of mild pain in the hip joint. Joints "stick" as they move.
Treatment is conservative (lasting 10-18 months) and surgery. During the surgical intervention, the dislodged mass was removed and the consistency of the articular surface was restored (comparability).
Diabetic Osteoarthropathy
Violation of glucose metabolism leads to circulatory disturbances and innervation of all organs. Changes in the hip are usually unilateral: on the right side, it occurs more frequently than on the left side. The immune response is reduced, which makes the body more susceptible to infection.
Clinical pictures:
- Swollen joints.
- The skin on top is cold to the touch.
Diabetic Osteoarthropathy No Pain Syndrome!
Treatment includes careful monitoring of blood sugar levels and prompt administration of insulin.
pseudogout
This pathology is the deposition of calcium salts in articular cartilage.
Doctors associate it with endocrine diseases: hyperparathyroidism, diabetes, gout, etc.
symptom:
- It starts with acute pain in the hip joint.
Several types of calcium salts are known. Some of them (pyrophosphates) are painless.
- Its movement is limited and it is difficult to abduct the leg to one side.
- Edema and hyperemia are characteristic.
- Elevated body temperature and fever.
To date, there is no specific treatment. Exacerbations can be stopped by intraarticular administration of corticosteroids and nonsteroidal anti-inflammatory drugs.
intermittent hydrojoint
This is a chronic disease characterized by increased production of synovial fluid. prone to frequent recurrence.
It is mostly diagnosed in women aged 20-40.
Cause unknown. There are two theories for the occurrence of this disease: injury-related and caused by endocrine disorders.
The joints become larger and stiffer.
The attack will go away on its own within 3-5 days.
Drug treatment is ineffective. Recurrence can occur even after surgery.
synovial chondromatosis
This benign metaplastic disorder replaces synovial collagen with cartilage. The structure of the articular surface changes, as do its properties.
Men have a much higher chance of developing chondromatosis, mainly middle-aged and older adults.
The cause is unknown.
Local swelling, limited joint function, creaking at work, joint pain.
Treatment is just surgery.
Hip Pain in Children and Adolescents
Epiphyseal dissolution
This pathology is most typical in children during adolescence (11 to 16 years). At this point, there was a sharp jump in growth. Because of the weak growth zone, the HBA slips into the neck, causing discomfort in the hip joint.
The child feels pain in the thigh that spreads to the groin and knee. Noticing lameness, but still relying on limbs.
The disease is corrected with surgery. You should start treatment as soon as possible. Otherwise, slippage of the HBA can lead to the development of arthropathy and joint inflammation.
Dysplasia
It is an over-formation of connective tissue that can replace bone elements. As a result, solid anatomical structures become plastic and pliable. The ligaments, meniscus, and tendons weaken. An unstable hip joint is formed, characterized by frequent dislocations.
Stunting is a genetic disorder that usually occurs in babies between 3 months and 1 year of age. Orthopedic surgeons can easily cope with the correction of the leg setting.
Latent forms may appear during adolescence.
If you find that your child has clubfoot or foot deformities, then you need to go to the hospital to check your baby's musculoskeletal system!
The later dysplasia is detected, the more problematic its treatment is.
osteochondrosis
This group of diseases includes lesions of bone and cartilage tissue with aseptic necrosis in the most loaded areas.
Etiology: Genetic susceptibility, hormonal imbalance, and infection can trigger this condition.
In 30% of cases, the hip joint is affected. These are mainly childhood diseases and are common in adolescents during growth spurts.
Adults should initially determine the location and nature of pain, contact their 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 is more commonly affected.
The cause of the pathological condition is the disruption of blood circulation in the upper part of the leg and the addition of cartilage tissue in the process.
Clinical pictures:
- Initially, the femoral head is painful. The joint pain disappeared suddenly as the necrosis progressed. This indicates the death of sensitive organ receptors.
- Gait changes - the child begins to limp.
- Movement in TBS is limited.
- Mostly unilateral.
Complications: dislocation, hip joint disease, lower extremity deformity, muscle atrophy.
Diagnostic measures
Before prescribing treatment, a doctor must carefully study the chief complaint, past medical history, and conduct an examination.
In the case of hip disease, the following studies are necessary:
- Laboratory blood tests (with inflammation, increased ESR, and leukocytosis).
- Joint plain radiographs of two or more projections.
- MRI with or without contrast.
- MSCT. It is used to check for the presence of sarcomas.
- Bone imaging. radionuclide method. The most common and informative type of bone tissue examination.
- Ultrasound of the hip joint.
- Density determination. Bone density and strength need to be determined.
If the patient is unable to sit up and has no pain relief, he is immediately taken to the hospital for further surgical treatment.
When to see a doctor urgently
- Severe pain when the hip moves.
- If unable to support the affected leg.
- Detection of edema in the lumbar spine and femoral region.
- Redness or bruising on the affected area.
There are some folk remedies for pelvic joint pain relief. It's not worth it to rely on these tips for a quick cure. Without a thorough diagnosis, it is impossible to determine the cause of joint pain, and self-medication can lead to the development of complications.