Pain in the hip joint

The hip joint, which has a strong, complex structure and withstands large loads, is subject to various pathologies that cause pain and development.

Hip pain occurs for the following reasons:

• injuries;
• contagious infection;
• destructive processes in the joints;
• inflammation;
• metabolic disorders.

A person can feel "giving" in the groin, hip, knee. Perhaps the appearance of lameness, muscle atrophy, their weakness, limited functionality of the limbs.

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

• start (until you "fall apart");
• at night;
• evening;
• constant (mild, medium, strong).

Why the leg hurts in the hip area

There are quite a lot of articular and extra-articular diseases that cause pain syndrome. Among them:

• coxarthrosis;
• arthritis of various nature;
• false speech;
• Kening's disease;
• fractures, dislocations, bruises;
• tendinitis;
• myositis;
• bursitis.

Pain in the hip joint: which doctor should I see?

Obviously, the number of pathologies that cause pain or numbness in the hip area cannot be treated by a specialist. Most likely, you should contact a traumatologist or rheumatologist. It is possible that a consultation with a surgeon is required. A person can turn to a neurologist due to the fact that the pain "shoots" in the groin, hip, lower abdomen. Thus, coxarthrosis is "masquerading" as sciatica, problems with nerve roots, herniated discs. However, the opposite situation is also possible when neurological pathologies are suspected, but an articular disease is detected.

Women often cannot distinguish the cause of pain in the groin - inflammation of the appendages or a joint disease. A trip to the gynecologist will clarify. A urologist will help men determine whether they have prostate gland pathologies.

Diagnostic measures

In medical practice, a well-coordinated scheme has been developed, the use of which allows you to completely 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 anamnesis. A person is asked about lifestyle, physical activity, find out if there are relatives suffering from joint diseases. External examination and palpation of the joint is also performed. In the presence of inflammation, this will help to narrow down the range of hypothetical diseases that cause pain.

In addition, various laboratory tests and hardware studies are prescribed. As a rule, apply:

• tomography;
• radiography;
• endoscopy.

You need immunological and microbiological blood tests, a test for rheumatoid factor. It may be necessary to check the synovial fluid of the joint.

Treatment methods

Due to the fact that pathologies are quite diverse, it is impossible to treat them according to a single scheme. For example, inflammation of the hip joint, its symptoms and treatment will be different from that of an injured doctor. 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 drug groups:

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

In this case, the treatment is long-term, with several courses that can last several years. In addition to drug therapy, a person does exercises, makes an effort to lose weight, undergoes physiotherapy procedures. If the patient cannot be helped by conservative methods, he is forced to use surgical methods.

How does the hip joint hurt, what symptoms characterize diseases that can cause pain, we reviewed traditional methods of treatment. However, various joint diseases have been known to man for thousands of years. Therefore, traditional medicine has developed a significant amount of knowledge on how to help a patient suffering from joint problems. Of course, taking herbal medicines, lotions, compresses, decoctions and tinctures cannot be the main method of treatment, but doctors recommend it as an addition to the main therapy. By yourself, without consulting a specialist, you can not drink or apply anything, because there is a danger of allergies, burning or just spending time and effort without getting results.

Treatment of pain in the hip joint with folk remedies helps to achieve an anesthetic effect and strengthen the body. Often, alternative medicine offers public components: burdock roots, lard, garlic, cinquefoil, dandelion, leaves of berry bushes, buds and fruits. For example, ordinary rosehip broth is a storehouse of vitamin C and is an excellent diuretic that removes excess fluid and unnecessary salts, reducing the burden on the legs and heart.

Pain spreads to the leg when walking - causes, symptoms

If you feel pain while walkingthighcovers the bodylower backIf it is localized in the lower leg or hip area, you need to see a doctor. diseases of the hip joints exposed to high loads duringwalk, jogging, fitness classes are progressing rapidly and can lead to disability. Monitor the health of the musculoskeletal system so that movement brings joy and benefit. If there are signs of pain, you should be examined as soon as possible and start treatment. In most diseases, bone tissue, cartilage and joints are destroyed, they cannot be restored. It is only possible to eliminate the inflammatory process, stop or slow down their destruction.

general description

The hip joint is multiaxial, cup-shaped. It unites the pelvis and femur into a single system that allows a person to walk, liftleglift and set aside. It works on every step, squat. Although the joint is healthy, we do not feel it. But with inflammation, pinchthey are nervous, there is aching, worsening or sharp pain. localized inthigh, but spreads as the disease progresses,gives backinleg, inlower back.

If nottreatinflammatory process:

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

Prevention

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

Destruction of cartilage and bone tissue occurs due to lack of calcium and other trace elements. Include more vegetables, lean fish, dairy products, cheeses in the menu. Take mineral-vitamin complexes recommended by your doctor. Avoid injury. Do not wear uncomfortable shoes. Walk more 2-3 times a weekdoexercises to strengthen and stretch muscles.

Causes of pain

Hipcan beget sick:

• after an awkward fall, impact - if the pain does not go away within 2-3 days, you need to visit a traumatologist,doradiography;
• with the development of arthrosis - the joint becomes inflamed, the pain is felt at rest and intensifies.walk;
• with arthritis - aching pain, worse at night;
• disruption of metabolism, blood flow - tissues do not receive enough nutrients and oxygen, the removal of toxins is delayed;
• if an infection enters - scratches, scratches, purulent rashes on the thigh can be a door for infection, penetrating the joint, causing acute infectious bursitis with severe unbearable pain;
• diabetes mellitus, with other systemic diseases;
• with inflammatory processes in the body, accompanied by fever or with the risk of joint spread.

It is impossible to make an accurate diagnosis on your own. For pain that does not go away for 2-3 days, you should consult a doctor.dorequest.

Types of pain

Acute pain in the hip joint occurs with injuries and local inflammatory processes. can start withrightorleftside, but with the development of inflammation it surroundships,gives backinlower back, inlegs. After the examination, the doctor will prescribe anti-inflammatory drugs that will quickly relieve the pain. However, sometimes it is required to continue treatment after the disappearance of the causes of inflammation.

With painful pain, it is more difficult for the doctor to make the correct diagnosis. It can originate in one place and give to another place. If it appears from time to time, you should pay attention to what its manifestations are associated with: at rest, withwalk, squatting, sudden movements.

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

Diseases and their characteristic symptoms

In painthighoccurs with various diseases:

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

Bursitis

Bursitis is an inflammatory process in the articular bag. It is manifested by acute pain, fever, deterioration of general well-being. A painful, hot bump appears under the skin.It healsThis 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, metabolic disorders, extreme stress and heavy physical work in athletes. A feeling of fatigue at the initial stagewalkpain with sudden movementsleg.If you start treatment at an early stage, the development of osteoarthritis can be greatly slowed down and motor function can be preserved in old age. In the second stage, destructive processes acting togetherthey are nervous. The pain starts in the morning and disappears in the afternoon. He canto returnon your kneeslower back. There is tissue swelling. With the development of arthrosis, pain continues day and night, mobility is limited.

Coxarthrosis

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

Arthritis

Aching pain externallyhipship many consider symptomsosteochondrosis. However, 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

Tendinitis - inflammation of ligaments and tendons manifests itself with unbearable pain, swelling, redness of the skin, crackling sound when walking, fever. There may be inflamed tissuepinchnerve endings that intensify the pain symptom. This is prohibitedtreatown painkillers. Such treatment can cause complications - the development of tendinosis, when the inflamed ligaments begin to collapse.

Neuralgia

If athe hip hurts, it gives in the legburning pain along the lateral surface, additional examinations are performed to confirm neuralgia,pinched nerve causes.

Other symptoms

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

• when walking, running, bending, the joint snaps or clicks;
• flexibility is lost, freedom of movement is limited - it is difficult to bend, climb stairs, sit;
• body temperature rises,osteochondrosisthere is no such symptom;
• gait changes;
• pain symptoms appear when walking, trying to lift, pull the leg aside, but the movements of the body and hands do not cause discomfort.

Diagnosis of pathology

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

• blood test - shows whether there is an inflammatory process in the body, how strong it is;
• urinalysis - reveals hidden edema, disorders 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;
• x-ray - shows the condition of bones, cartilages, tendons, reveals fractures, cracks, breaks, dislocations, level of destruction or deformation;
• magnetic resonance or computed tomography is necessary to see the pathology of soft tissues: muscles, ligaments;
• Ultrasound - shows the state of the joints, the 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 pathologies of the hip joint. If arthritis only needs medicationpinchnerve endings are different. After making a diagnosis, the doctor prescribes 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 development of the disease, patients take hormonal drugs. In addition to drug treatment, physiotherapy is also carried out.

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 an injection solution after studying the characteristics 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 corticosteroids is carried out.

In the early stages of coxarthrosis, treatment with anti-inflammatory drugs is effective. But if the patient did not go to the doctor when he felt itit hurtsWhen walking and the disease progresses, a full or partial joint replacement is necessary. Chondoprotectors are prescribed to restore cartilage tissue.

Glucocorticosteroids are prescribed in pathologies of connective tissues.

It is impossible to use strong drugs independently without a doctor's supervision. During the therapy, the doctor monitors the general condition of the body, periodically prescribes blood and urine tests.

What to do with an inflamed hip joint, how to treat it

Septic arthritis of the hip. Diagnosis and treatment

Septic arthritis- the average age for childhood disease and arthritis of the hip joint is lower than for arthritis of other localizations: 70% of cases occur in children under 4 years of age. 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 oneresearch, when the authors excluded all patients who refused to walk because of obvious prior pathology, bacterial infection was found to be the cause in 21 of 22 patients. Osteomyelitis and septic arthritis occurred with equal frequency and accounted for 14 of 22 cases. Discitis also occurred in a significant number of cases.
It has increasedtemperatureit was present in 82% of patients with bacterial infection and only 17% of those without infection. The number of leukocytes in blood and ESR did not increase.

Pathogenesis of septic arthritis of the hip joint

Horseseptic arthritis of the hipIn the inflammatory process, Staphylococcus aureus is grown most 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 come to the surface as a subperiosteal abscess.

Inflammation of the hip jointit usually develops due to the introduction of the pathogen into the joint capsule from the focus of osteomyelitis in the neck of the femur. 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 be the result of hematogenous spread during generalized septicemia.

articular cartilagecannot withstand the articular pressure caused by pus caused by staphylococci. In addition, staphylococci produce an activator of staphylokinase, which contributes to the destruction of articular cartilage. Cartilage can resist these forces for 4-5 days before destructive changes begin. Other organisms that can cause septic arthritis of the hip in children include pyogenic strep and Pfeiffer's bacillus.

streptococcal infectionusually accompanied by a more rapid progression of signs and symptoms. Although Pfeiffer bacillus infection usually occurs in the first 2 years of life, it is responsible for septic arthritis that develops in children in the first 12 months of life. Gonococcal arthritis should be suspected in young adults.

Clinical picture of septic arthritis of the hip joint

Usually,childHe presented to the emergency department with high fever, irritability, and severe pain in the affected hip joint, with significant limitation of motion 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.

Numberleukocytessynovial fluid averages 57, 000 µl, but can vary from 10, 000 to 250, 000 µl. Shifting of the formula to the left is characteristic, blood cultures are positive in more than 50% of cases. In most of the examined patients, the mucin level in the synovial fluid was decreased in all cases, as well as the glucose level compared to its content in the blood. Erythrocyte sedimentation rate is usually increased.

In one study, all patients had some degree of soft tissue swelling in the hip. The younger the child, the more likely it is to detect the expansion of the joint space. In another study, many patients initially had normal radiographs. The most characteristic was the pathological subluxation of the femur with the expansion of the joint cavity. Some patients had osteomyelitis of the proximal femur.

Differential diagnosis of septic arthritis of the hip

Septic arthritis of the hipmust be distinguished from a number of other diseases. Transient synovitis can present with severe pain, severe lameness, and limited range of motion in the hip joint. Radioisotope scanning helps distinguish this disease from septic arthritis. If it is not possible to carry out, a skin pull in the hospital bed will help to make a differential diagnosis. Significant improvement of the condition with reduction of symptoms within 24 hours indicates transient synovitis.

If the doctor suspectsseptic arthritis, the joint should be punctured, the effusion should be removed and antibiotic treatment should be started. Hemophilia can be difficult to distinguish, 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 articular pressure.

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

Treatment of septic arthritis of the hip

Perhaps the most importantmomentWhat the emergency physician should be aware of is that delayed diagnosis and delayed initiation of treatment worsens the prognosis and outcome of this disease. In one study, a poor outcome was noted in almost all cases where treatment was initiated more than 4 days after the onset of symptoms.

The goal 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 disruption of the blood supply to the epiphysis. Adequate doses of parenteral antibiotics are required. Initially, it is recommended to use antibiotics from the penicillin group, but recently other drugs are preferred. An important component of the treatment is the puncture and washing of the joint cavity. The physician should select the appropriate antibiotic based on the most likely microorganism based on the patient's age and onset characteristics. Inoculation and Gram stain play an important role in antibiotic selection.

Most often foundstaphylococcal arthritis, suitable for treatment with methicillin or oxacillin. If gonococcal arthritis is suspected in adults, it is recommended to prescribe intravenous penicillin at a dose of 10 million IU per 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. Of course, the sooner the diagnosis is made, the easier it is to control the disease and prevent relapses. With a disease in stage 1-2, if you follow some rules and restrictions, it is quite possible to live and feel comfortable.

Treatment will be effective only after a comprehensive diagnosis. In this case, the task of treating arthrosis is to increase the joint space, restore the efficiency of the joint and restore the cartilage tissue as much as possible.

If you experience frequent or recurring hip 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 is happy with the lack 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 call has already been made.