Coxarthrosis(arthrosis of the hip joint) is a type of deforming arthrosis of the joints, a chronic non-inflammatory disease that affects the hip joints (one or both at the same time). This disease has a degenerative-dystrophic nature. This means that the cartilage that forms the hip joint undergoes degenerative changes, and at the same time it changes the surfaces of the bones. In addition, bone growths (osteophytes) are formed, the joint is deformed, the range of motion in the affected joint decreases, and they become extremely painful and uncomfortable.
The hip joint is one of the largest joints in our body. Thanks to it, a very important motor function is performed in the human body, and it is also responsible for ensuring that our body can move. If the hip joint gets sick, it affects the whole body and prevents a person from living peacefully, walking, and doing sports. Very often we see elderly people who have to rely on canes due to hip joint disease.
Although the hip joint is extremely massive and strong, it is also quite sensitive, especially over time. Hip joint pain significantly reduces the quality of human life.
Coxarthrosis (arthrosis of the hip joint)After gonarthrosis (arthrosis of the knee joint), it takes a solid second place among arthrosis of the joints in terms of the frequency of diagnosed cases.
Classification of coxarthrosis (arthrosis of the hip joint)
It happenscoxarthrosisboth primary and secondary.
- Primary coxarthrosis is mainly caused by the inevitable wear and tear of the hip joints during life and usually affects people after the age of 40.
- The causes of secondary coxarthrosis are usually the following diseases: congenital dislocation of the femur, necrotic masses of the femur in the head region, Peter's disease, previous traumatization of the femur, inflammatory diseases of the femur. Wherearthrosis of the hip jointit can affect either one joint or both.
There are several types of coxarthrosis:
- Dysplastic (congenital pathology characterized by underdevelopment of the joint).
- Involutive (characteristic of people in the older age category and associated with age-related changes).
- Post-infectious (before that there was purulent or purulent-allergic, rheumatoid arthritis).
- Disease associated with Peters disease (development of osteochondropathy in the head of the femur).
Coxarthrosisdue to trauma (neck and bone head (femur) fractures).
- Coxarthrosis due to metabolic disorders (metabolism).
- Dyhormonal (taking glucocorticosteroids, antidepressants for a long time).
- Idiopathic (the cause cannot be determined).
Symptoms of coxarthrosis (arthrosis of the hip joint)
In order to correctly describe the symptoms of coxarthrosis, it is necessary to take into account the stages of the disease, because the symptomatology depends on the stage of the disease.
Stages of coxarthrosis (arthrosis of the hip joint)
In general, there are three stages of coxarthrosis (arthrosis of the hip joint):
- 1st stage of coxarthrosis. This is the early stage of the disease where the symptoms are still mild. At this stage, the joint does not hurt much, and the pain occurs only after physical exertion, such as lifting heavy objects or running, walking long distances. After a person rests, the pain disappears. If the patient walks, for example, more than two kilometers, lameness may also develop. Pain increases when climbing stairs. The motor volume of the joint is slightly reduced or maintained. X-ray examination can show only small changes in bone structures.
- 2nd stage of coxarthrosis. This stage develops when the first stage is not treated. A special cracking (creaking) in the joint is added to the above symptoms. The pain gets worse and starts to spread to the groin, and may also spread to the thigh and knee. At this stage, it is not only strong, but any movement can cause pain symptoms, even a slight load on the hip joint. Even getting out of bed or turning the trunk 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 begin to limp even after small walks (up to 500 meters). At this stage, the disease forces a person to rely on a cane while walking. Limitation of movements in the joint becomes more prominent. According to the results of X-ray diagnostics, emerging osteophytes are identified.
- 3rd stage of coxarthrosis. The last 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 immobile. Due to muscular dystrophy, the muscle mass in the thighs and hips decreases, which is very noticeable. Characteristic is that it is impossible for the patient to stand directly while the body is bent. Any arthrosis leads to the formation of a contracture (bent position), in this case, the contracture is also caused by the constant tension of the muscle fibers, the leg on the side of the lesion is shortened. As a result of immobility of the hip joint, the entire leg stops performing its motor function, which has a very negative effect and causes osteochondrotic damage. 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. It is typical for older people. The hip joint wears out over time, it stops performing its functions over time, "drying up", which causes its shock absorber function to decrease and the bones forming the joint to rub against each other.
- Damage to the hip joint. The most common injury among people in this age group is a fracture of the femoral neck, which threatens with disability if not properly treated. The joint can be damaged at any age, but older people suffer more.
- Disturbed metabolism. This is typical for people with metabolic disorders and diseases associated with impaired metabolism.
- Hormonal disorder. It is more typical for women who take antidepressants and glucocorticosteroids for a long time.
- Hereditary anomalies in the development of the musculoskeletal system, as well as congenital anomalies. Unfortunately, at this time, quite a large number of children are born with congenital pathologies of the musculoskeletal and nervous systems. As for anomalies in the development of the hip joint, it can include dysplasia, in which several structures of the joint are not developed.
- Systemic arthritis. Damage to several joints can also cause 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 these can also cause the appearance of pain in the hip joint. Such diseases that cause joint pain under investigation include: rheumatism; rheumatoid arthritis; spondyloarthropathy; juvenile rheumatoid arthritis.
- Defeat of osteochondrosis. Osteochondrosis of the spine is a very common and serious disease that can "turn off" other structures of our body in addition to the spine, especially 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 both the joint itself and the femur. Such lesions are very serious because they lead to 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 pre-pubertal children. More often, an abscess in the pelvic region, which is the result of an untreated or poorly treated infectious process, for example, appendicitis, inflammatory processes, especially in the genital organs of women (ovarian disease), the development of an abscess in the area of ischiorectal deepening, which leads to impaired walking (the appearance of lameness). In most cases, pain and lameness are the result of compression or damage to nearby nerves (sciatica or obturator).
- Neoplasms of a malignant nature. Very rarely, malignant neoplasms affect the hip joint and the bones surrounding it, because more often the cause of the disease is metastasis from other malignant regions, for example, breast or lung cancer.
- Narrowing of the lumen of the aorta and iliac arteries (stenosis and blockage). At the same time, the joint receives less and less nutrients necessary for its normal functioning, which leads to its degeneration.
Risk group for coxarthrosis (arthrosis of the hip joint).
The main risk group may include the following categories of people and harmful factors:
- Elderly people. This disease is characteristic of old people, the elderly, because degeneration processes occur at this age.
- A woman. According to statistics, women are more prone to hip joint problems.
- People who are overweight or obese.
- Previous trauma to one or both hip joints.
- Hereditary predisposition to such diseases and congenital anomalies in the development of the hip joint.
- The presence of infectious lesions in the past, for example, abscesses, aseptic necrosis of the femoral head, osteomyelitis, etc.
- Heavy physical labor.
- Summer residents with a very high risk of developing coxarthrosis.
Prevention of coxarthrosis (arthrosis of the hip joint)
The main measures to prevent coxarthrosis are as follows:
- Moderate physical activity. Then it is important to do gymnastics and joint kneading to prevent the development of pathological processes and slower aging. This will help to improve not only the condition of the hip joint, but also the whole body.
- If there are metabolic disorders, they should be corrected. To do this, you need to contact a specialist.
- Watch your weight. Remember that the hip joint already carries a large load, it carries almost the entire body, so you should not interfere with it to perform its functions. In addition, too much weight will put so much pressure on the joints that they will gradually collapse. Overweight people are also prone to metabolic disorders.
- Avoid sharp turns of the body, especially if you are not warmed up and ready, this will prevent injury to the head and neck of the femur.
- Of course, it is better to choose a sport where joint damage is least dangerous, such as swimming or yoga, especially if there are hereditary tendencies or developmental anomalies.
- Propensity to joint diseases implies careful treatment with them, as well as regular visits to the doctor in order not to miss the possible development of the disease or any other pathological process in the joint.
- If a child is diagnosed with hip dysplasia, it should be treated, and immediately! It is better to allow the child to be immobilized for a few weeks at an early age than to suffer for the rest of his life.
- Timely 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 discussed above, there are many reasons, they are different andtreatment of osteoarthritis of the hip, accordingly, will differ radically. Sometimes it is not so easy, and sometimes it is not possible at all. Emphasis is placed on studying the manifestations of the disease and choosing the appropriate treatment.
First of all, the patient is carefully questioned by the doctor, his complaints, causes of the disease, hereditary load, presence of injuries, etc. It is very important to have the complaints described above and for how long the patient has been observed.
After the interview, the doctor personally examines the affected area for inflammatory changes, trophic changes, deformations, limb shortening, asymmetries, etc. Children may have a "click" symptom.
An important point is additional examination methods - computed and magnetic resonance imaging, ultrasound and X-ray examination, because they will help to make a final diagnosis. This item is extremely important in the differential diagnosis of coxarthrosis from other diseases of the hip joint.