Coxarthrosis(arthrosis of the hip joint) is a type of deforming arthrosis of the joints, 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. Further, bone growths (osteophytes) are formed, the joint deforms, the volume of movement in the affected joint decreases, and they become 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 performed in the human body, and he is also responsible for ensuring that our body is able to move. If the hip joint becomes ill, then this affects the whole body as a whole and prevents a person from living peacefully, walking, not to mention playing sports. Very often we see older people who are forced to rely on a cane due to a disease of the hip joint.
Despite the fact that the hip joint is extremely massive and strong, at the same time it is quite vulnerable, especially over time. Soreness of the hip joints significantly reduces the quality of human life.
Coxarthrosis (arthrosis of the hip joint)firmly ranks second 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 in the course of life, and usually affects people after 40 years of age.
- The causes of secondary coxarthrosis are usually the following diseases: congenital femoral dislocation, damage by necrotic masses of the hip bone in the region of its head, Peter's disease, traumatization of the earlier hip joint, inflammatory diseases of the hip joint. Whereinarthrosis of the hip jointcan affect either 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 for people of the older age category and is 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 bone (femoral)).
- Coxarthrosis due to metabolic disorders (metabolism).
- Dishormonal (taking glucocorticosteroids, antidepressants for a long time).
- Idiopathic (the cause of which could not be established).
Symptoms of coxarthrosis (arthrosis of the hip joint)
In order to correctly describe the symptoms of coxarthrosis, one should simultaneously consider the stages of the disease, because the symptomatology also depends on the stage of the disease.
Stages of coxarthrosis (arthrosis 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 soreness occurs only after physical exertion, such as lifting heavy objects or jogging, hiking for long distances. After the person rests, the pain disappears. The patient may also develop lameness if, for example, he walks more than two kilometers on foot. Increases soreness going up stairs. The motor volume of the joint decreases slightly or is preserved. X-ray examination can show only small changes in the 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. Soreness becomes more intense and begins to radiate to the groin area, and can also spread to the thigh and knee. At this stage, not only strong, but also any movements can cause pain symptoms, even a slight load on the hip joint. Even getting out of bed or spinning 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 begin to limp even after minor walks (up to 500 meters). At this stage, the disease already forces a person to rely on a cane when walking. The limitation of movements in the joint becomes more pronounced. According to the results of X-ray diagnostics, the 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, several times increases the pain symptoms. At this stage, the hip joint is completely immobilized. Muscle mass in the thigh and buttocks is reduced due to muscular dystrophy, which is very noticeable. Characteristic is the impossibility of direct standing of the patient, while the body will be skewed. Any arthrosis leads to the formation of a contracture (flexion 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. As a result of 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 lesion. In addition, the spine also suffers, there are sensations 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 older people. The hip joint wears out over time, ceases to perform its functions over time, "dries out", which leads to a decrease in its shock-absorbing function and friction of the bones that form the joint against each other.
- Injury to the hip joint. The most common injury among 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.
- Disturbed metabolism. This is typical for people with a history of metabolic disorders and diseases associated with impaired metabolism.
- Violation of the hormonal status. More characteristic of women, especially those who have been taking antidepressants and glucocorticosteroids for a long time.
- Hereditary anomalies in the development of the musculoskeletal system, as well as congenital anomalies. Unfortunately, at the moment, a fairly large number of children are born with congenital pathologies of the musculoskeletal and nervous systems. As for the anomalies in the development of the hip joint, this can include its dysplasia, in which several structures of the joint do not develop.
- Systemic arthritis. Damage to several 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 conditions and chronic arthritis. All this can also lead to the appearance of pain in the hip joint. Such diseases that cause pain in the studied joint include: rheumatism; rheumatoid arthritis; spondyloarthropathy; juvenile rheumatoid arthritis.
- The defeat of osteochondrosis. Osteochondrosis of the spinal column is a fairly common and serious disease that, in addition to the spine, can "disable" other structures of our body, in particular, the hip joint.
- Muscles and ligaments of the joint. Damage to these structures can also be a consequence of the occurrence 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 may occur, which simply "eats" or "dissolves" bone tissue. Tuberculous lesions may also occur, and more often such localization occurs in children of the pre-pubertal period. Abscessing in the pelvic area, which is more often the result of an untreated or poorly treated infectious process, for example, with appendicitis, inflammatory processes, especially when it comes to the genital organs of women (ovarian disease), the development of an abscess in the area of the ischiorectal deepening, which leads to impaired gait(appearance of lameness). In most cases, soreness and lameness are the result of compression or damage to nearby nerves (sciatic or obturator).
- Malignant neoplasms. Quite 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 areas, for example, with 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 nutrients necessary for normal functioning, which leads to its degeneration.
Risk group for coxarthrosis (arthrosis of the hip joint)
The following categories of people and harmful factors can be included in the main risk group:
- Older people. This disease is typical for older people, the elderly, because degeneration processes occur that occur precisely in this age period.
- Female. According to statistics, women are more prone to problems with the hip joints.
- People who are overweight or obese.
- Previous trauma to one or both hip joints.
- Hereditary predisposition to this kind 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, and so on.
- Hard physical labor.
- Summer residents who have an extremely high risk of developing coxarthrosis.
Prevention of coxarthrosis (arthrosis 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 in it and its slower aging. This will help not only improve the condition of the hip joint, but also the whole body.
- If there are metabolic disorders, they should be corrected. To do this, you should contact a specialist.
- Watch your weight. Do not forget that the hip joint already bears a heavy load, almost the entire body, so you should not interfere with it to perform its functions. In addition, a lot of 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 not prepared, this will prevent you from injuring the head and neck of the femur.
- It is better, of course, to choose the sport in which the least dangerous joint injuries, such as swimming or yoga, especially if there are hereditary predispositions or developmental anomalies.
- Predisposition to joint diseases implies careful handling of them, as well as regular trips to the doctor in order 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, it should be treated, and immediately! It is better to let the child be immobilized for a few weeks at an early age than to suffer all 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 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. Emphasis is placed on the study of the manifestations of the disease and the selection of appropriate treatment.
First of all, the patient is carefully interviewed by the doctor, studying in detail the complaints, the causes of the disease, hereditary burden, the presence of injuries, and so on. 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 changes, trophic, deformities, shortening of the limbs, asymmetries, and so on. And 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. In the differential diagnosis of coxarthrosis from other diseases of the hip joint, this item is extremely important.