Coxarthrosis(osteoarthritis of the hip joint) is a type of joint deforming osteoarthritis, which is a chronic, non-inflammatory disease that affects the hip joints (one or both at the same time). This disease has a degenerative-dystrophic character. This means that the cartilage that forms the hip joint undergoes degenerative changes, while also changing the surfaces of the bones. In addition, bone growths (osteophytes) form, the joint deforms, the volume of motion in the affected joint decreases and becomes extremely painful and uncomfortable.
The hip joint is one of the largest joints in our body. It is thanks to him that a very important motor function is carried out in the human body, and he is also responsible for ensuring that our body is able to move. If the hip joint becomes ill, it affects the whole body as a whole and prevents a person from living peacefully, walking, not to mention playing sports. Very often we see elderly people who have to lean on a cane due to hip joint disease.
Despite the fact that the hip joint is extremely massive and strong, at the same time it is quite vulnerable, especially over time. Pain in the hip joints significantly reduces the quality of human life.
Coxarthrosis (osteoarthritis of the hip joint)firmly occupies the second place among arthrosis of the joints in terms of the frequency of diagnosed cases after gonarthrosis (arthrosis of the knee joint).
Classification of coxarthrosis (arthrosis of the hip joint)
It happenscoxarthrosisboth primary and secondary.
- The cause of primary coxarthrosis is mainly the inevitable wear and tear of the hip joints during life and usually affects people after 40 years.
- The causes of secondary hip osteoarthritis are usually the following diseases: congenital femoral dislocation, necrotic masses of the hip bone in the area of his head, Peter's disease, trauma to the anterior hip joint, inflammatory diseases of the hip joint. hip joint. Whereosteoarthritis of the hip jointcan affect one joint separately, or both.
There are several types of coxarthrosis:
- Dysplastic (is a congenital pathology and is characterized by underdevelopment of the joint).
- Involutive (typical in older people and associated with age-related changes).
- Post-infectious (it was preceded by purulent or purulent-allergic rheumatoid arthritis).
- Illness due to Peters disease (development of osteochondropathy in the head of the femur).
- Coxarthrosisdue to trauma (fractures of the neck and head of the (femoral) bone).
- Coxarthrosis due to metabolic disorders (metabolism).
- Deshormonal (prolonged intake of glucocorticoids, antidepressants).
- Idiopathic (the cause of which could not be established).
Symptoms of coxarthrosis (osteoarthritis of the hip joint)
In order to correctly describe the symptoms of coxarthrosis, one should simultaneously consider the stages of the disease, since the symptomatology depends on the stage of the disease.
Stages of coxarthrosis (osteoarthritis of the hip joint)
In total, there are three stages of coxarthrosis (arthrosis of the hip joint):
- 1st stage of coxarthrosis. This is the initial stage of the disease, in which the symptoms are still mild. The joint at this stage does not hurt much, and the pain occurs only after physical exertion, such as lifting heavy objects or jogging, hiking for long distances. After the person rests, the pain goes away. The patient may also develop a limp if, for example, he walks more than two kilometers on foot. Increases pain when climbing stairs. The motor volume of the joint decreases slightly or is maintained. X-ray examination can only show small changes in bone structures.
- 2nd stage of coxarthrosis. This stage develops in the absence of treatment of the first stage. To the above symptoms, a specific crack (crunch) in the joint is added. The pain becomes more intense and begins to radiate to the groin area, and may also spread to the thigh and knee. At this stage, not only strong movements, but also any movements can cause painful symptoms, even a slight load on the hip joint. Even getting out of bed or twisting your torso can cause pain. There is tension in the periarticular muscles, which does not go away even at night, so patients often complain that the thigh hurts at night. A person can start limping even after small walks (up to 500 meters). At this stage, the disease already forces a person to lean on a cane to walk. The limitation of movement in the joint becomes more pronounced. According to the results of X-ray diagnostics, emerging osteophytes are determined.
- 3rd stage of coxarthrosis. The final stage of the disease. At this stage, the pain becomes permanent and torments the patient. Any movement, even the weakest, increases the symptoms of pain several times. At this stage, the hip joint is completely immobilized. The muscle mass in the thigh and buttocks is reduced due to muscular dystrophy, which is very noticeable. Characteristic is the inability to stand directly from the patient, while the body will be askew. Any arthrosis leads to the formation of a contracture (bending position), in this case, the contracture is also formed due to the fact that the muscle fibers are in constant tension, while the leg on the side of the lesion becomes shorter. Due to the fact that the hip joint is immobilized, the entire leg ceases to perform its motor function, which has a very negative effect and leads to their osteochondrotic injury. In addition, the spine also suffers, there are feelings of discomfort and pain in the sacral region.
Causes of coxarthrosis (arthrosis of the hip joint)
The main causes of coxarthrosis:
- Age-related changes in the joint. Typical for the elderly. The hip joint wears out over time, ceases to perform its functions over time, "dry up", which leads to a decrease in its function of absorbing shocks and friction of the bones that form thearticulation against each other.
- Hip joint injury. The most common injury in people of this age group is a fracture of the femoral neck, which threatens with disability in the absence of proper treatment. The joint can be injured at any age, but older people are more likely to suffer from it.
- Disturbed metabolism. This is typical for people with a history of metabolic disorders and diseases associated with impaired metabolism.
- Violation of hormonal status. It is more characteristic of women, especially those who have been taking antidepressants and glucocorticoids for a long time.
- Hereditary anomalies in the development of the musculoskeletal system, as well as congenital anomalies. Unfortunately, at present, quite a large number of children are born with congenital pathologies of the musculoskeletal and nervous systems. As for abnormalities in the development of the hip joint, this may include its dysplasia, in which several structures of the joint do not develop.
- Systemic arthritis. Damage to multiple joints can also lead to damage to the hip joint. In this case, one of the main risk factors will be the presence of an inflammatory process.
- Rheumatic diseases and chronic arthritis. All this can also lead to the appearance of pain in the hip joint. Such diseases that cause pain in the joint being studied include: rheumatism; rheumatoid arthritis; spondyloarthropathy; juvenile rheumatoid arthritis.
- The defeat of osteochondrosis. Osteochondrosis of the spine is a fairly common and serious disease that, in addition to the spine, can "turn off" other structures in our body, in particular, the hip joint.
- Muscles and ligaments of the joint. Damage to these structures can also be the result of degenerative and dystrophic processes in the hip joint.
- Infectious lesions of the joint itself and of the femur. Such lesions are very serious, as they entail serious consequences and are sometimes difficult to treat. Osteomyelitis can occur, which simply "eats" or "dissolves" bone tissue. Tuberculous lesions can also occur, and more often such localization occurs in children of the pre-pubertal period. Abscess in the pelvic region, which is most often the result of an untreated or poorly treated infectious process, for example, with appendicitis, inflammatory processes, especially in relation to the female genitalia (ovarian disease), the development of an abscess in the area of ischiorectal deepening, which leads to an impaired gait (appearance of lameness). In most cases, pain and lameness are the result of compression or damage to nearby nerves (sciatic or obturator).
- Tumors of a malignant nature. Very rarely, malignant neoplasms affect the hip joint and the bones around it, since most often the cause of the disease is metastasis from other malignant areas, for example, breast or lung cancer.
- Narrowing of the lumen of the aorta and iliac arteries (their stenosis and occlusion). At the same time, the joint receives less and less of the nutrients necessary for its normal functioning, which leads to its degeneration.
Coxarthrosis risk group (arthrosis of the hip joint)
The main risk group may include the following categories of people and harmful factors:
- Older people. This disease is typical for old people, old people, because degenerative processes occur precisely in this age period.
- Female. According to statistics, women are more prone to problems with hip joints.
- Overweight or obese people.
- Previous trauma to one or both hip joints.
- Hereditary predisposition to this type of diseases and congenital anomalies in the development of the hip joint.
- The presence in the past of infectious lesions, such as abscesses, aseptic necrosis of the head of the hip bone, osteomyelitis, etc.
- Hard physical labor.
- Summer residents who have an extremely high risk of developing coxarthrosis.
Prevention of coxarthrosis (osteoarthritis of the hip joint)
The main measures for the prevention of coxarthrosis are as follows:
- Dosed physical activity. It is important to do gymnastics and knead the joint to prevent the development of pathological processes and its slower aging. This will help not only to improve the condition of the hip joint, but also of the whole body.
- If there are metabolic disorders, they must be corrected. To do this, you need to contact a specialist.
- Watch your weight. Do not forget that the hip joint already carries a significant load, almost the whole body, so you should not interfere with it to perform its functions. Also, a lot of weight will put such pressure on the joints that they will gradually collapse. Overweight people are also prone to metabolic disorders.
- Avoid sharp body turns, especially if you are not warmed up and unprepared, this will prevent you from injuring your head and femur neck.
- It is better, of course, to choose the sport in which joint injuries are less dangerous, such as swimming or yoga, especially if there are hereditary predispositions or developmental anomalies.
- A predisposition to joint diseases implies careful handling of them, as well as regular visits to the doctor so as not to miss the possible development of a disease or any other pathological process in the joint.
- If a child is diagnosed with hip dysplasia, they must be treated, and immediately! It is better to leave the child immobilized for a few weeks at an early age than to suffer all his life.
- Prompt treatment of infectious diseases, especially those that threaten to spread to the hip joint.
Diagnosis of coxarthrosis (arthrosis of the hip joint)
When diagnosing coxarthrosis, it is very important to find the cause that caused it. After all, as we have already discussed above, there are many reasons, they are diverse andhip osteoarthritis treatment, respectively, will differ radically. Sometimes it's not that easy, and sometimes it's not possible at all. The emphasis is on studying the manifestations of the disease and choosing the appropriate treatment.
First, the patient is carefully questioned by the doctor, studying in detail the complaints, the causes of the disease, the hereditary burden, the presence of injuries, etc. It is very important to have the complaints described above and how long they have been observed in the patient.
After the interview, the doctor personally examines the affected area for the presence of inflammatory, trophic changes, deformities, shortening of the limbs, asymmetries, etc. And children may have a "clicking" symptom.
An important point is additional examination methods - magnetic and computerized resonance imaging, ultrasound and x-ray, as they will help to make a final diagnosis. In the differential diagnosis of coxarthrosis from other diseases of the hip joint, this element is extremely important.