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, also changing the surfaces of the bones. Further, bone growths (osteophytes) are formed, the joint is deformed, 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. Thanks to it, a very important motor function is performed in the human body, and it is also responsible for ensuring that our body is able to move. If the hip joint gets sick, then it affects the whole body as a whole and prevents a person from living in peace, walking, not to mention playing sports. Very often we see elderly 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. Hip joint pain significantly reduces the quality of human life.
Coxarthrosis (arthrosis of the hip joint)ranks strongly second among joint arthrosis 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 damage to the hip joints during life, and it 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 hip bone in the region of the head, Peter's disease, traumatization of the early hip joint, inflammatory diseases of the hip joint. Wherearthrosis of the hip jointit can affect one joint alone, or both.
There are several types of coxarthrosis:
- Dysplastic (it 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 (preceded by purulent or purulent-allergic, rheumatoid arthritis).
- Disease due to Peters disease (the development of osteochondropathy in the femoral head).
Coxarthrosisdue to trauma (fracture of the neck and head of the bone (femur)).
- Coxarthrosis due to metabolic disorders (metabolism).
- Dyhormonal (taking glucocorticosteroids, antidepressants for a long time).
- Idiopathic (the cause of which cannot be determined).
Symptoms of coxarthrosis (arthrosis of the hip joint)
To correctly describe the symptoms of coxarthrosis, the stages of the disease must be considered simultaneously, because the symptomatology 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):
- The first stage of coxarthrosis. This is the initial stage of the disease, in which the symptoms are still mild. This joint at this stage does not hurt much and pain appears only after physical exertion, such as lifting heavy objects or running, walking long distances. After the person rests, the pain disappears. The patient may also develop a limp if, for example, he walks more than two kilometers. Increases pain by climbing stairs. The motor volume of the joint decreases slightly or is preserved. X-ray examination can show only small changes in bone structures.
- The second stage of coxarthrosis. This stage develops in the absence of treatment of the first stage. A specific crack (jumps) in the joint is added to the above symptoms. The pain becomes more intense and begins to radiate to the hip area, and can also spread to the thigh and knee. At this stage, not only strong, but also any movement can cause pain symptoms, even a light load on the hip joint. Even getting out of bed or turning 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 rely on a cane when walking. The limitation of joint movements becomes more pronounced. According to the results of X-ray diagnostics, the appearing osteophytes are determined.
- The third 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 pain symptoms several times. At this stage, the hip joint is completely immobile. Muscle mass in the thighs and buttocks decreases due to muscular dystrophy, which is very visible. Characteristic is the impossibility of the patient standing upright, while the body will be tilted. 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 immobilization of the hip joint, the whole 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 is 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 joints. Typical for the elderly. The hip joint wears out over time, ceases to perform its functions over time, "dry out", which leads to a decrease in its shock-absorbing function and the friction of the bones that form the joint against each other.
- Hip joint injury. The most common injury in people of this age group is a fracture of the neck of the femur, which threatens with disability in the absence of proper treatment. This joint can be damaged 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 hormonal status. It is more characteristic for women, especially for those who have been taking antidepressants and glucocorticosteroids for a long time.
- Inherited anomalies in the development of the musculoskeletal system, as well as congenital anomalies. Unfortunately, at the moment, a large number of children are born with congenital pathologies of the musculoskeletal and nervous system. As for abnormalities in the development of the hip joint, this may include its dysplasia, in which some joint structures do not develop.
- Systemic arthritis. Damage to certain 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.
- Loss of osteochondrosis. Osteochondrosis of the spine 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.
- Joint muscles and ligaments. 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 "disintegrates" bone tissue. Tubercular lesions can also appear, and more often such localization occurs in pre-pubescent children. Abscess in the pelvic area, which is most often the result of an untreated or poorly treated infectious process, for example, with appendicitis, inflammatory processes, especially when it comes to the female genital organs (ovarian disease), the development of an abscess. in the area of ischiorectal deepening, which leads to impaired walking (appearance of lameness). In most cases, pain and lameness are the result of compression or damage to nearby nerves (sciatica or obturator).
- Neoplasms of 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 areas, for example, with breast or lung cancer.
- Narrowing of the lumen of the aorta and iliac arteries (stenosis and their closure). 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 main risk group may include the following categories of people and harmful factors:
- Elderly people. This disease is typical for the elderly, the elderly, because degeneration processes occur that occur precisely in this age period.
- Female. 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 this type of disease 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 femoral head, osteomyelitis, etc.
- Heavy physical work.
- Summer residents who have an extremely high risk of developing coxarthrosis.
Prevention of coxarthrosis (arthrosis of the hip joint)
The main measures to prevent coxarthrosis are as follows:
- Dosed physical activity. It is important to do gymnastics and cook 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 must be corrected. To do this, you need to contact a specialist.
- Watch your weight. Remember that the hip joint already carries a large load, almost the entire body, so you should not interfere with it to perform its functions. In addition, a large 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 unprepared, this will prevent you from injuring the head and neck of the femur.
- 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 abnormalities.
- A predisposition to joint diseases means careful treatment 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 joints.
- If a child is diagnosed with hip dysplasia, it must be treated, and immediately! It is better to let the child be immobilized for a few weeks at a young 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 discussed above, there are many reasons, they are different andTreatment of osteoarthritis of the hip, respectively, will change 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 interviewed 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, deformations, shortening of limbs, asymmetry, etc. 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 establish a final diagnosis. In the differential diagnosis of coxarthrosis from other diseases of the hip joint, this article is extremely important.