Pain in the hip joint

Powerful, complex in structure, bearing great loads, the hip joint is subject to various pathologies that lead to the appearance and development of pain.

Hip pain occurs due to:

• injuries;
• infectious infection;
• destructive processes in joints;
• inflammation;
• metabolic disruptions.

A person can feel that he "gives" in the hip, buttocks, knee. Perhaps the appearance of lameness, muscle atrophy, their weakness, limited functionality of the limbs.

Practice shows that the nature and intensity of the pain syndrome can be different:

• starting (until you "dissolve");
• at night;
• evening;
• constant (light, medium, strong).

Why does the leg in the groin area hurt?

There are many articular and extra-articular diseases that lead to pain syndrome. Among them:

• coxarthrosis;
• arthritis of various natures;
• pseudogout;
• Kenning's disease;
• fractures, dislocations, bruises;
• tendinitis;
• myositis;
• scholarship.

Hip pain: which doctor should I go to?

It is clear that the number of pathologies that lead to hip pain or numbness cannot be treated by a specialist. Most likely, you should contact a traumatologist or rheumatologist. A consultation with a surgeon may be required. Due to the fact that the pain "shoots" in the groin, buttocks, at the bottom of the abdomen, a person can be referred to a neurologist. So coxarthrosis "masks" as sciatica, nerve root problems, disc herniation. But the opposite situation is also possible, when neurological pathology is suspected, but an articular disease is detected.

Women often cannot distinguish the cause of pain in the groin - inflammation is the appendix or joint disease. A visit to the gynecologist will bring clarity. A urologist will help men determine if there is any pathology of the prostate.

Diagnostic measures

In medical practice, a well-coordinated scheme has been developed, the use of which allows you to fully determine why the hip joint hurts, what to do and how to treat it.

During the first visit, the doctor's task is to collect an anamnesis. A person is asked about his lifestyle, physical activity, find out if he had any relatives who suffered from joint diseases. An external examination of the joint and its palpation is also performed. In the presence of inflammation, this will help narrow the circle of hypothetical diseases that cause pain.

Further, various laboratory tests and hardware studies are scheduled. Normally, go to:

• tomography;
• radiography;
• endoscopy.

You will need immunological and microbiological blood tests, a test for rheumatoid factor. You may need to examine the joint's synovial fluid.

Methods of Treatment

Due to the fact that the pathologies are quite different, they cannot be treated according to a single scheme. For example, inflammation of the hip joint, its symptoms and treatment will be different from the work of a doctor with an injury. In case of a fracture or dislocation, a rheumatologist or surgeon will prescribe immobilization of the joint. In infectious and purulent pathologies, it is necessary to take a course of antibiotics.

Inflammatory and degenerative diseases require the use of the following groups of drugs:

• non-steroidal;
• diuretics;
• chondroprotectors;
• muscle relaxants;
• vitamin complexes.

In this case, the treatment is long, it is carried out with several courses, which can last several years. In addition to drug therapy, a person performs exercises, makes efforts to reduce weight, undergoes physiotherapy procedures. If it is not possible to help the patient with conservative methods, surgical methods should be used.

How does the hip joint hurt, what symptoms characterize the diseases that can cause pain, we have examined traditional treatment methods. However, various joint diseases have been known to man for thousands of years. Therefore, traditional medicine has developed a considerable amount of knowledge on how to help a patient who is concerned about joints. Of course, herbal medicine, creams, compresses, ingestion of decoctions and tinctures cannot be the main method of treatment, but doctors recommend it as an addition to the main therapy. On your own, without consulting a specialist, you can not drink or apply anything, because there is a risk of getting an allergy, a burn or just a waste of time and effort without getting results.

Treatment of pain in the hip joint with folk remedies helps to get an anesthetic effect, to strengthen the body. Most often, alternative medicine offers public components: burdock roots, lard, garlic, red leaf, dandelion, berry bush leaves, buds and fruits. For example, ordinary rose juice is a storehouse of vitamin C and an excellent diuretic that removes excess fluid and unnecessary salts, reducing the load on the legs and heart.

Pain radiates to the leg while walking - causes, symptoms

If you feel pain while walkingthighcovering the body fromlower backon the lower part of the leg, or located in the groin area, you should see a doctor. Diseases of the hip joints, which experience high loads for a long timewalking, running, fitness classes, progress rapidly and can lead to disability. In order for movement to bring joy and benefit, monitor the health of the musculoskeletal system. If there are symptoms of pain, you should be examined and start treatment as soon as possible. In most diseases, bone tissue, cartilage and joints are destroyed, which cannot be restored. You can only remove the inflammatory process, stop or slow down their destruction.

general description

The hip joint is multiaxial, cup-shaped. It combines the pelvis and femur into a single system, which allows a person to walk, liftlegit is lifted and set aside. It works with every step, squat. While the joint is healthy, we do not feel it. But with inflammation, pinchingnerves, there is pain, intensification or sharp pain. It is located inthighbut as the disease progresses it spreads,give backINleg, inlower back.

If nottreatinflammatory process:

• the size of the articular bag decreases, which contains synovial fluid - an intra-articular lubricant that reduces friction and slows the wear of the joints;
• the membranes that protect the joint are damaged;
• cartilage, bone tissue is destroyed.

prevention

It is possible to protect hip joints from destruction, maintain mobility until old age, if you monitor your health. Diseases of the musculoskeletal system provoke excess weight. It increases the load on the joints and they wear out faster. Not only body weight in kilograms and height is important, but also the ratio of muscle and fat tissue. Strong, trained in the gym, the muscles form a muscular corset that supports the body in an upright position, reduces the load on the back, hip and knee joints and legs.

The destruction of cartilage, bone tissue occurs with a lack of calcium and other trace elements. Include more vegetables, lean fish, dairy products, cheeses in the menu. Take the mineral-vitamin complexes recommended by your doctor. Avoid injuries. Do not wear uncomfortable shoes. I walk more, 2-3 times a weekI DOexercises to strengthen and stretch muscles.

Causes of pain

Hipmaybeill:

• after a hard fall, blow - if the pain does not go away within 2-3 days, you should visit a traumatologist,I DOradiography;
• with the development of arthrosis - the joint becomes inflamed, the pain is felt at rest and intensifies withwalking;
• with arthritis - painful pain, aggravated at night;
• in violation of metabolism, blood flow - the tissues do not receive enough nutrients, oxygen, the removal of toxins is delayed;
• if an infection enters - scratches, scrapes, purulent rashes on the thigh can become a gateway for infection, penetrating the joint, causes acute infectious bursitis with acute unbearable pain;
• with diabetes mellitus, other systemic diseases;
• with inflammatory processes in the body, accompanied by fever or with the risk of spreading to the joint.

It is impossible to make an accurate diagnosis yourself. For pain that does not go away for 2-3 days, you should go to the doctor.I DOthe survey.

Varieties of pain

Acute pain in the hip joint occurs with injuries and local inflammatory processes. It can start withSTRAIGHTorleftlateral, but with the development of inflammation, it covers the perimeterhips,give backINlower back, inpins. The doctor, after the examination, will prescribe anti-inflammatory drugs that will quickly relieve the pain. But sometimes it is required to continue the treatment after its disappearance to remove the causes that caused the inflammation.

With excruciating pain, it is more difficult for a doctor to make an accurate diagnosis. It can be born in one country and given to another. If it appears periodically, you should note what its manifestations are associated with: at rest, withwalking, meetings, sudden movements.

If pain symptoms appear for more than 6 months, the disease has become chronic. To establish the diagnosis, hardware examinations are performed: X-ray, ultrasound, MRI,is being doneblood test.

Diseases and their characteristic symptoms

Pain inthighappear with various diseases:

• scholarships;
• osteoarthritis;
• coxarthrosis;
• arthritis;
• inflammation of ligaments;
• neuralgia.

bursitis

Bursitis is an inflammatory process in the articular sac. Appears with acute pain, fever, deterioration of general well-being. A painful and hot lump forms under the skin.curesThis disease is an orthopedic traumatologist.

Osteoarthritis

A chronic disease in which the bone and cartilage tissues of the joint are destroyed. It develops after injuries, during menopause in women, with metabolic disorders, with excessive stress in athletes and during heavy physical work. You feel tired in the early stageswalkingpain with sudden movementsthe legs.If you start treatment at an early stage, the progression of osteoarthritis can be greatly slowed and motor activity can be maintained in old age. In the second stage, destructive processes affect the jointsnerves. The pain appears in the morning and disappears in the afternoon. She cangiveon your knees,lower back. There is tissue swelling. As osteoarthritis progresses, pain continues around the clock, mobility is limited.

Coxarthrosis

With coxarthrosis, the composition of the synovial fluid changes. It does not lubricate the components of the joint and with every movement severe pain is felt, the head of the femur is displaced and deformed. The disease develops in old age or after injuries. In the initial stage, aching pain is felt withSTRAIGHTorleftsideways while walking. When it is under deformationpinched nerves, the pain intensifies, lameness appears. In the third stageleftorSTRAIGHTthe leg is shortened due to the deformation of the femoral head, the difference can be 1-1. 5 cm.

Arthritis

Aching pain externallyhipships much consider symptomsosteochondrosis. But when making a diagnosis, it is necessary to exclude or confirm arthritis with hardware diagnostics. Different types of arthritis are diagnosed: purulent, rheumatoid, tuberculous, psoriatic, reactive.

Inflammation of the ligaments

Tendonitis - inflammation of ligaments, tendons is manifested by unbearable pain, swelling, reddening of the skin, cracking while walking, fever. Inflamed tissue cantipnerve endings, which increase pain symptoms. it's bannedtreathis pain medication. Such treatment can give complications - the development of tendinosis, when the inflamed ligaments begin to collapse.

Neuralgia

If onehip hurts, gives in legburning pain along its lateral surface, additional examinations are performed to confirm neuralgia,Causes of nerve compression.

Other symptoms

To understand if there is a pathology in the hip joint or if the pain is caused by the fact thatosteochondrosis gives in the legs, the following symptoms will help:

• when you walk, run, bend, the joint jumps or clicks;
• flexibility is lost, freedom of movement is limited - it is difficult to bend, climb stairs, sit down;
• body temperature risesosteochondrosisthere is no such symptom;
• changes in gait;
• pain symptoms appear when you walk, try to lift, move the leg aside, but the movements of the body and hands do not cause discomfort.

Pathology diagnosis

INosteochondrosisand pathologies of the hip joint similar symptoms. To make an accurate diagnosis, the doctor examines the patient, explains the complaints, the nature and localization of the pain. To define,how to treat the diseasewhich drugs are contraindicated for the patient, additional examinations are prescribed:

• a blood test - shows whether there is an inflammatory process in the body, how strong it is;
• urine analysis - reveals hidden edema, disturbances in the excretory system, the degree of intoxication of the body;
• blood test for the amount of fibrinogen, other non-specific markers;
• rheumatic tests - determine the rheumatoid factor;
• proteinogram - detects inflammatory processes, malignant and benign neoplasms, characterizes the composition of protein compounds in the blood;
• radiography - shows the condition of bones, cartilage, tendons, reveals fractures, cracks, ruptures, dislocations, the degree of destruction or deformation;
• Magnetic resonance or computed tomography is needed to see soft tissue pathology: muscles, ligaments;
• Ultrasound - shows the condition of the joints, an increase in the volume of their membranes during inflammation, the presence of synovial fluid in different parts of the joint.

Features of the treatment of pain of a different nature

There is no single scheme for the treatment of hip joint pathologies. Arthritis only needs medication ifstucknerve endings are different. The doctor, after the diagnosis, prescribes the treatment, taking into account the stage of the disease, gender, age of the patient, other chronic diseases and possible allergic reactions.

Painful sensations, inflammation in arthritis are suppressed by anti-inflammatory drugs. To prevent the progression of the disease, patients take hormonal drugs. In addition to drug therapy, physiotherapy is performed.

Bursitis is treated with non-steroidal anti-inflammatory drugs. If the tests show a strong inflammatory process, injections are made directly into the joint. The doctor chooses a solution for injection, after studying the features of the course of the disease, the general condition of the patient's body. With a high risk of complications, a severe course of the disease, treatment with a corticosteroid is carried out.

In the initial stages of coxarthrosis, treatment with anti-inflammatory drugs is effective. But if the patient did not go to the doctor when he felt thisacheleg when walking, and the disease is advanced, a full or partial joint replacement is needed. To restore cartilage tissue, chondroprotectors are prescribed.

In connective tissue pathologies, glucocorticosteroids are prescribed.

It is impossible to use powerful drugs on your own, without the supervision of a doctor. During therapy, the doctor monitors the general condition of the body, periodically prescribing blood and urine tests.

Inflamed hip joint what to do how to treat

Septic arthritis of the hip. Diagnosis and treatment

Septic arthritis- a disease of childhood, and for the hip joint, the average age is even lower than for arthritis of other localization: 70% of cases occur in children under 4 years old. The younger the child, the worse the outcome of hip arthritis. A child's refusal to walk is often associated with bacterial infections of the hip joint.

In oneexplorative, during which the authors excluded all patients who refused to walk because of an obvious previous pathology, it was found that in 21 of 22 patients the cause was a bacterial infection. Osteomyelitis and septic arthritis occurred with equal frequency and accounted for 14 cases out of 22. Discitis also occurred in a significant number of cases.
Grown upthe temperatureit was in 82% of patients with bacterial infection, but only in 17% of those without infection. The number of leukocytes in the blood and ESR did not increase.

Pathogenesis of septic arthritis of the hip joint

INseptic arthritis of the hipIn the inflammatory process, Staphylococcus aureus is grown more often. The infection usually affects the joint cavity from an osteomyelitic focus within the joint capsule. Osteomyelitis, as a rule, is of hematogenous origin and affects the metaphysis of the thigh, penetrating through the supply vessels. The infection may surface in the form of a subperiosteal abscess.

Inflammation of the hip jointusually develops due to the penetration of the pathogen from the focus of osteomyelitis in the neck of the femur into the joint capsule. There is a significant difference between the development of the disease in older and younger children. In older children, this disease is usually the result of osteomyelitis of the femoral neck. In infants, it may result from hematogenous dissemination in generalized septicemia.

articular cartilageit cannot withstand the increased intra-articular pressure caused by the pus produced by staphylococci. In addition, the staphylococcus produces an activator of staphylokinase, which contributes to the destruction of articular cartilage. Cartilage can withstand these forces for 4-5 days before destructive changes begin. Other organisms that can cause septic hip arthritis in children include pyogenic streptococcus and Pfeiffer's bacillus.

streptococcal infectionit is usually accompanied by a much more rapid increase in signs and symptoms. Pfeiffer bacillus infection is usually responsible for septic arthritis that develops in children in the first 12 months of life, although it can occur in the first 2 years of life. Gonococcal arthritis should be suspected in the young.

Clinical presentation of septic arthritis of the hip joint

Usually,childYou are admitted to the emergency room with high fever, irritability and severe pain in the affected hip joint, accompanied by significant limitation of movement in all directions and muscle spasm. The child walks with a limp or refuses to walk at all. The affected hip is flexed, externally rotated, and abducted. During the examination, the patient has pain in the groin and above the hip joint, intoxication.

Numberleukocytesin synovial fluid, on average, it is 57, 000 µl, but it can vary from 10, 000 to 250, 000 µl. A shift of the formula to the left is characteristic, blood cultures are positive in more than 50% of cases. The level of mucin in the joint fluid is decreased in all cases, as well as the level of glucose compared to its content in the blood in most of the examined patients. The erythrocyte sedimentation rate is usually increased.

In one study, all patients had some degree of soft tissue swelling in the hip area. The younger the child, the more likely he is to discover an expansion of the shared space. In another study, many patients had normal radiographs at baseline. The most typical was a pathological subluxation of the hip with widening of the joint space. Some patients had osteomyelitis of the proximal femur.

Differential diagnosis of septic arthritis of the hip

Septic arthritis of the hipit must be differentiated from a number of other diseases. Transient synovitis can manifest with severe pain, severe lameness and limitation of movement in the hip joint. Radioisotope scanning helps to distinguish this disease from septic arthritis. If it is not possible to carry out, pulling the skin at the hospital bed will help to make a differential diagnosis. A significant improvement in the condition with a decrease in symptoms within 24 hours indicates transient synovitis.

If the doctor doubtsseptic arthritis, the joint should be punctured, the effusion removed and antibiotic treatment started. Hemophilia can be difficult to differentiate, but such patients are usually registered for this disease. If this disease is suspected, urgent decompression is indicated to prevent damage to the femoral head due to increased intra-articular pressure.

Rheumatic attackmay present with significant pain and limited range of motion in the hip joint. As a rule, with this disease there is unstable arthritis and arthralgia, which helps in the differential diagnosis.

Treatment of septic arthritis of the hip

Perhaps the most importantmomentWhat the emergency physician should know is that the delay in the diagnosis of this disease and the delayed start of the treatment worsens the prognosis and the outcome of this disease. In one study, a poor outcome was observed in almost all cases when treatment was started more than 4 days after the onset of symptoms.

Purpose of treatment- removal of effusion from the joint to prevent the destruction of articular cartilage and the formation of adhesions, as well as decompression of the joint to prevent impaired blood supply to the epiphysis. Adequate doses of parenteral antibiotics are required. Initially, the use of antibiotics from the penicillin group is recommended, but recently other drugs have also been preferred. An important component of treatment is drilling the joint cavity and washing it. The physician should select the appropriate antibiotic based on the most likely suspected microorganism based on the patient's age and onset characteristics. An important role in the choice of antibiotic is played by inoculation and gram staining.

It is more often foundstaphylococcal arthritis, suitable for therapy with methicillin or oxacillin. If gonococcal arthritis is suspected in adults, it is recommended to prescribe penicillin intravenously in a dose of 10 million IU / day.

Unfortunately, a way to completely get rid of coxarthrosis has not yet been invented. Even joint arthroplasty does not guarantee that dystrophic changes will stop in it. Of course, the earlier the diagnosis is made, the easier it is to keep the disease under control and prevent recurrence. With a disease in stages 1-2, it is quite possible to live and feel comfortable if you follow some rules and restrictions.

Treatment will be effective only after a comprehensive diagnosis. The task of treating osteoarthritis in this case is to increase joint space, restore joint efficiency and, as far as possible, regenerate cartilage tissue.

If you are experiencing frequent or recurring pain, don't turn a blind eye to it. Will it be possible to detect the disease at an early stage? You can stop the disease and prevent its development. If the doctor will satisfy you with the absence of a serious diagnosis, so much the better! Continue to lead a healthy lifestyle and do not forget to visit the orthopedist regularly - after all, the first alarm bell has already sounded.