Musculoskeletal diseases in most cases are accompanied by organ dysfunction, causing a lot of inconvenience to the patient.
An important symptom of musculoskeletal disorders is pain. Joint damage is especially annoying.
The hips are the largest of them all. Pain in the case of defeat can be localized both around and cause different anatomical structures: to the organs of the small pelvis, lower back or thighs.
General classification of causes
The causes of hip pain are varied.
In medicine, the following causes of joint pain are conditionally distinguished:
- Inflammatory and infectious processes inside the joint and surrounding tissues of the joint.
- Degenerative diseases of the musculoskeletal system.
- Injured.
- Fibroids and soft tissue.
There are other specific causes of joint pain:
- piriformis syndrome. Regarding her prolonged contractions.
- Necrosis of the femoral head (GBC). Usually it is a complication of another pathology of TBS.
- Legg-Calve-Perthes disease. She is a GBC osteopathic physician.
- Dissection of bone necrosis. In different sources, it may be referred to as Koenig's disease.
- Osteoarthritis diabetes. Complications of diabetes.
- Fake. Also chondrocalcinosis.
- Intermittent hydrocephalus is an overproduction of synovial fluid.
- Cochlear choroiditis (Lotch syndrome).
In addition, the legs in the hip joint area in pregnant women are also often painful.
During this period, complex hormonal changes occur, the growing uterus moves nearby organs and strains the ligamentous apparatus of the hip joint. In addition, weight gain increases the load on the legs. If dietary recommendations are not followed, pregnant women can develop calcium deficiency, due to an imbalance of this mineral, the structure of bones and joints is disturbed.
Cause of pain
The prevalence of joint pain increases with age.In children, symptoms of TBS (hip) disease occur with a frequency of no more than 10%, and in the elderly - from 50%. Mostly women suffer from this pathology. This is due to age-related hormonal changes after menopause.
Why does the hip joint hurt? There is no definite answer to this question, as the list of reasons is quite long.
The main factors that cause joint pain in the hip joint:
- Pathological process inside the musculoskeletal apparatus. Usually, this is the result of direct mechanical impact: bruising of the joint is followed by inflammation of the joint components.
- Anatomical changes in joints. They can be congenital or post-traumatic (dislocation, fracture).
- Pathology of other systems. Inflammation of the organs of the MT (small pelvis) can spread to the pelvis. Neurological disorders are manifested by pain of any localization. Metabolic disorders cause imbalance of minerals. The connection between bones and ligaments weakens, and the risk of injury increases.
Inflammatory and infectious processes in joints and surrounding tissues
The most common cause of joint pain in any locale is musculoskeletal plasticity.
Hip arthritis is classified into:
- Primary school. It is formed with the direct penetration of pathogens into the joint: a blow with a sharp or blunt object with wound formation.
- Second. TBS infection occurs from a distant foci of inflammation: by contact or by blood.
TBS arthritis
Mainly occurs in elderly patients.Pain in the hip joint, aggravated by walking, radiating to the groin, perineum, and thighs. It is difficult for the patient to get up from a chair or climb stairs without assistance. Discomfort worse in the morning.
Therapy includes administration of anti-inflammatory drugs and the introduction of glucocorticoids into the ocular fluid. If necessary, its cavity is drained.
Rheumatoid Arthritis (RA)
It is a chronic systemic connective tissue disease similar to polyarthritis.The essence of this pathological process is inflammation of the bursa, cartilage and joint capsule. It is caused by a dysfunctional immune system. Characterized by polymyalgia, morning stiffness, possibly high fever.
Affected shoulder and hip joints are extremely rare, with pain appearing only in the late stages of RA a few years after the onset of the disease.
Acute infectious arthritis
It is an infectious disease of young children, 70% of cases occur in infants under 4 years of age. The causative agent is usually Staphylococcus aureus. The child refuses to walk because of severe acute pain in the hip and hip joints when moving. Characterized by high fever and increased irritability.
Treatment is by removing excess fluid from the joint cavity and treating with antibiotics.
The risk of developing osteomyelitis and sepsis is high.
Tuberculosis or arthritis
Often, pediatricians are faced with this disease. In young children, the immune system is underdeveloped leading to the possibility of infection.
This disease is characterized by a slow progression. At first, children get tired very quickly, reduce activity, run away. Over time, thigh muscle atrophy occurs. Movements are impeded. Hip pain in children is characterized by severe pain, longer limbs than healthy children.
If pus drains the synovial membrane, the secretions will spread along the muscles and tendons, forming blisters and fistulas.
In the absence of complications, conservative treatment is performed.
Tendonitis in the hip joint
This pathology is inflammation of the tendon of the muscle and its vagina. Caused by prolonged use or foot injury.
The main manifestations: pain in the femoral joint with movement, swelling lesions, changes in gait - limping becomes conspicuous.
Treatment - medication: anti-inflammatory drugs, intra-articular corticosteroid injection.
Bursitis
Of all the synovial sacs, the synovial cyst is the most commonly inflamed.It partially covers the femur. With hip bursitis, the pain radiates down the thighs and buttocks. The patient cannot lie on his side: the pressure in the synovial sac increases and the pain is severe.
If there are no complications with bursitis, then treatment consists of removing the lower extremities with a cane or crutches.
Medications: Pain relievers and corticosteroids.
Idiopathic ankylosing spondylitis
This is a chronic inflammation of the spine and elements of the sacral joints.
This disease is dangerous with complications that reduce living standards and lead to disability.
If you find such a problem, you should immediately contact a specialist to be prescribed the correct treatment method.
The cause is not entirely clear. Modern medicine believes that the leading cause is genetic. Usually people under the age of 30 get the disease.
Symptoms of idiopathic ankylosing spondylitis:
- Increased body temperature, fever.
- Intoxication syndrome: irritability, weakness, anorexia, weight loss, sleep disturbances.
- A dull, constant pain in the hip joint, as well as at the sacral and buttock level, radiating along the back of the thigh. Often bilateral, at night their intensity increases.
- Limited mobility in the lower back and hips. This symptom gradually shifts to the upper parts of the spine along the entire back, including the neck. As a result, the patient has a forced "claimer pose".
Rehabilitation therapy is based on physical therapy exercises specifically for the development of bones and joints.
Medications: NSAIDs for pain and inflammation, corticosteroids.
Tendonitis
Athletes or people with physically demanding jobs are prone to tendinitis. Features of the manifestation: pain in the hip joint occurs when subjected to a large load. At rest, unpleasant sensations are usually not observed.
It is recommended to reduce the load on the legs, in the case of elevation - rest in bed.
Drug therapy: NSAIDs, topical analgesic gels, glucocorticosteroids, chondroprotectors.
Syphilis
In the late stages of the disease, the musculoskeletal system is affected. The formation of gum is characteristic. Their excessive pathological mineralization occurs. TBS is extremely rare.
Gumma - a node in the tissue, formed during the progression of syphilis, destroys surrounding tissues. The process ends with the formation of rough scars.
Treatment is ineffective, the risk of developing complications in the form of osteomyelitis is high.
Fungal hip arthritis
It occurs due to prolonged use of antibiotics and due to diseases of the immune system.
People with HIV or AIDS are especially susceptible to fungal arthritis.
Pain in the joints is constant, of aching nature.
Fungal lesions of the bone are characterized by a propensity for fistula formation, prolonged duration, and difficulty in treatment.
Treatment: systemic antipyretic.
According to indications, surgical intervention is performed.
Tumors of bone and soft tissue
Cancers of the hip may be metastatic to distant organ cancers or arise independently.
- Benign tumors of bone tissue - osteosarcoma.
The formation that is foreign to the body develops, compressing the nerves and blood vessels. Clinic similar to piriformis syndrome.
- Malignant bone tumor - bone tumor.
The tumor rapidly increased in size, necrosis and disintegrated, and spread throughout the body.Nighttime hip pain is unbearable, they don't stop even with NSAIDs or attempts at anesthesia.
- Mesenchymal tumors are formed by soft tissues. Benign ones rarely recur and do not metastasize. Depending on how aggressive the malignant cells are, the intensity of the pain can vary.
Osteoarthritis disease
Coxarthrosis
Osteoarthritis of the hip is a chronic disease characterized by a change in the integrity of the joint surface due to a violation of metabolic processes. It grows very slowly, over several years. Initially, cartilage tissue is affected, then bone tissue, then varus deformity of joints and limbs. Occurs at the age of 40.
Symptom:
- The hip joint only hurts when walking.
- Stiffness of movements in TBS.
- As the process progresses, the length of the limb is observed.
- Weakness and atrophy of muscle mass.
- The lameness.
- When walking, you will hear a crunching sound.
- With bilateral lesions, a "duck gait" occurs - shifting from one leg to another.
Drugs: NSAIDs, vasodilators, muscle relaxants, chondroprotectors, injection of hormonal drugs into the joint cavity.
Topical action: ointments, lotions, compresses.
In the final stage of the disease, surgery is underway.
Bone tumor
Degenerative changes in the discs cause damage to surrounding tissues.
Symptom:
- Pain in the lower back that radiates to the hip and thigh joints.
- It's sudden, crisp and sharp. It starts at the waist and buttocks, and goes down the back of the legs.
- Unilateral localization of pain is more common.
- The patient is in the obligatory position - lying on the healthy side.
- It is possible to reduce the sensitivity of the skin of the feet.
Treatment is very complex. Anti-inflammatory drugs and analgesics, moderate physical activity (swimming), physiotherapy after remission of the most acute phenomena.
With pronounced pain, an anesthetic blockade should be performed.
Hurt
Injury
Pain of moderate intensity is characteristic, with active movement its intensity increases. The first time after a hip injury, the limp appeared, then quickly passed.
At rest, the symptoms disappear.
To quickly relieve pain in the case of a sacroiliac joint injury, it is necessary to apply cold to the injured area: ice or a frozen product.
hip dislocation
Probably:
- Natural. It is the result of an unsuccessful delivery or pathologies of intrauterine growth. The child has irregular gluteal folds and shortened extremities, possibly with pinched nerves, presenting with convulsions. If the dislocation is not corrected at an early age, the child may become disabled later in life.
- Pain. Signs: severe severe pain, complete cessation of joint function, edema and extensive hematoma appearing above the damaged area. The patient cannot get up from a chair or bed without assistance.
In the event of a hip dislocation, you should go to the emergency room or hospital right away.
fracture
The hip joint is made up of strong strong bones.
The most common diagnosis from this subgroup is a femoral surgical neck fracture. It is mainly intended for women after the age of 60.
The cause of such damage was a fall or impact in the area of TBS.
The pain is strongest, the hip is pulled and the abscess, movement in it is almost impossible. The upper thigh area is swollen, there is a large hematoma. The injured leg shortens, the patient limps. When moving, a characteristic click is heard.
When a bone is broken, the surrounding tissues are damaged, 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 the thigh.
Complex treatment: surgery and medicine.
Specific causes of joint pain
piriformis syndrome
With the localization of pathological processes in the area of the hip joint, the surrounding tissues are also affected. Long-term contraction of the piriformis muscle compresses the sciatic nerve and its vessels, causing a number of symptoms:
- Leg pain in the hip joint. She goes to the buttock and intervertebral joints.
- Increased discomfort when leaning on the affected leg.
- Compression of the piriformis muscle.
- Sudden "lumbar" pain along the nerve.
Etiology: trauma and infectious and inflammatory diseases of the pelvic organs, vertebral pathologies, overtraining, holding a non-physiological position for a long time.
Medications: NSAIDs, muscle relaxants, pain relievers, drugs that improve blood circulation, glucocorticoids.
After the collapse of acute phenomena, rehabilitation measures can be indicated: physical therapy, massage, acupuncture.
Sterile necrotic femoral head
Most occur in young men. The cause of the disease is ischemia in the upper thigh. With an inadequate blood supply to the tissues, their oxygen starvation occurs and their necrosis (necrosis) process begins.
Clinical picture: hip pain and flexion of the lower leg and perineum. Can't lean on the injured leg. After a few days, the nerve endings melt and the pain goes away. This is a terrible sign! With necrosis of the deeper layers of bone, the risk of rapid development of osteomyelitis and sepsis is high.
Treatment is surgery and drug therapy.
Koenig's disease
Osteoarthritis - sloughing off a small area of necrotic cartilage from the bone and its protrusion into the joint cavity.
This is a rare disease. Typical for males aged 15-35.
The patient complains of mild pain in the hip joint. Joints "stick" during movement.
Conservative treatment (duration 10-18 months) and surgery. During surgical intervention, the sloughing masses are removed, the uniformity (comparable) of the joint surfaces is restored.
Osteoarthritis diabetes
Violation of glucose metabolism leads to circulatory and visceral disorders of all organs. Changes in the hip are more often unilateral: on the right, it occurs more often than on the left. A weakened immune response makes the body more susceptible to infections.
Clinical picture:
- Joint swelling.
- The skin on it is cold to the touch.
No Pain Syndrome in Diabetic Osteoarthritis!
Treatment is by careful monitoring of blood glucose levels and prompt use of insulin.
fake
This pathology is the deposition of calcium salts in the joint cartilage.
Doctors associate it with endocrine pathologies: hyperparathyroidism, diabetes, gout, etc. v.
Symptom:
- Begins with acute pain in the hip joint.
Several types of calcium salts are known. With some of them (pyrophosphates), there is no feeling of pain.
- Movement in it is limited, it is difficult to pull the leg to the side.
- Edema and congestion are characteristic.
- Increased body temperature and fever.
To date, there is no specific treatment. An acute attack is stopped using intra-articular corticosteroids and NSAIDs.
Intermittent vitreous disease
This is a chronic disease, manifested by episodes of increased production of synovial fluid. prone to frequent relapses.
It is diagnosed mainly in women 20-40 years old.
The cause is unknown. There are two theories about the occurrence of this disease: related to trauma and due to endocrine disorders.
Joints increase in size, becoming stiff.
The attacks will go away on their own in 3-5 days.
Medical treatment is not effective. Relapse occurs even after surgery.
Joint chondromatosis
This benign metaplasia is the replacement of synovial collagen by cartilage. The structure of the joint surface changes, as do its properties.
The risk of chondromatosis is much higher in men, mainly in middle age and older.
The cause is not clear.
There is local swelling, limited function of joints, crunching when working, joint pain.
Treatment is only surgery.
Hip pain in children and adolescents
hemolysis
This pathology is most typical for children during puberty (from 11 to 16 years old). At this time, growth skyrocketed. Due to the weak growth zone, the HBA slides up the neck, leading to discomfort in the hip joint.
The child feels pain in the thigh, spreading to the groin and knee. The lameness was noted, but limb dependence was maintained.
The disorder is corrected by surgery. You should start treatment as soon as possible. Otherwise, slippage of the HBA can cause the development of joint disease and arthritis.
Dysplasia
It is the excessive formation of connective tissue that can replace bone elements. As a result, solid anatomical structures become flexible. Ligaments, meniscus, and tendons become weak. Unstable hips are formed, which is distinguished by frequent dislocations.
Dysplasia is an inherited disease that usually occurs in infants between 3 months and 1 year of age. Orthopedists can easily deal with adjusting the setting of the foot.
The latent form may appear in adolescence.
If you notice the signs of clubfoot, foot deformity in the child, the mother needs to quickly go to the hospital for a musculoskeletal examination for the baby!
The later dysplasia is discovered, the more problematic it is to treat.
Bone disease
This group of diseases includes lesions of bone and cartilage tissue, in which the most loaded areas suffer from sterile necrosis.
Etiology: genetic predisposition, hormonal imbalances and infections can cause this pathology.
In 30% of cases, the hip is affected. These are mainly childhood diseases that are common in adolescents during the period of growth spurts.
At the initial stage, adults should determine the location and nature of the pain, contact the 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 joint is more commonly affected.
The cause of the pathological condition is a violation of blood circulation in the upper part of the leg with the process of replenishing cartilage tissue.
Clinical picture:
- Initially, the femoral head is painful. With the progression of necrosis, the joint pain suddenly disappears. This indicates death of the organ sensitive receptors.
- Change in gait - the child begins to limp.
- Movement in TBS is restricted.
- Most often unilateral.
Complications: dislocation, joint stiffness, lower extremity deformity, muscle atrophy.
Diagnostic measures
Before prescribing treatment, the doctor must carefully study the complaints, medical history and conduct an examination.
In the case of hip disease, the following studies are needed:
- Laboratory blood tests (with inflammation, increased ESR and leukocytosis are noted).
- Plain radiographs of joints in two or more views.
- MRI with or without contrast.
- MSCT. It is used to check for the presence of a sarcoma.
- Bone technique. radionuclide method. This is the most common and most informative type of bone tissue test.
- Hip ultrasound.
- Measure density. Essential for determining bone density and strength.
If the patient is unable to sit or stand, and the pain cannot be relieved, the patient should be taken to the hospital immediately for further surgical treatment.
When to see a doctor urgently?
- When there is a sharp pain when moving in the hip joint.
- If unable to support the affected leg.
- Detect edema in the lumbar and femoral regions.
- Redness or bruising in the affected area.
There are folk ways to relieve pain in the pelvic joints. Relying solely on these tips for a quick cure is not worth it. Without a thorough diagnosis, the cause of joint pain cannot be determined, and self-medication leads to the development of complications.