One of the common symptoms with which patients come to a medical center is pain in the hip joint. The causes, treatment and possible diseases that cause such a manifestation cannot be identified without qualified medical care. Discomfort in any part of the musculoskeletal system may indicate the development of serious pathologies, so dysfunction of the hip joint should not be ignored.
Anatomy of the hip joint area.
The hip joint plays an important role in motor activity. This is one of the largest human joints, which can withstand heavy loads while standing, as well as when walking upright.
Bones that form a joint.
The hip joint is formed by the head of the femur and the acetabulum of the innominate pelvic bone, the largest and most powerful part of the human skeleton. The minimum number of anatomical elements of the joint ensures its strength and reliability, the ability to support body weight during movement. Most pathologies of the hip joint begin with damage to the acetabulum, the immobile part of the joint. It has the shape of a bowl, the center of which is directed upward at a slight angle, which ensures even distribution of the load between the bones of the pelvis.
The glenoid cavity is a strong and solid formation, consisting of 3 types of pelvic bones:
- ileal
- ischiatic
- pubic
The most vulnerable area of the joint cavity is found in children whose bone tissue is not strong enough. Due to the presence of a small bone ridge on the edge of the socket, the head of the femur is completely immersed in the "socket", which provides strong support for the limb. The moving part of the joint is the femur (head, neck, greater and lesser trochanter). The shape of the head corresponds to the cavity of the joint cavity. It is covered with cartilaginous tissue, which guarantees perfect alignment of the joint elements and their free sliding. In the center of the head is a strong ligament that connects the bone to the acetabulum, providing additional grip and support.
The neck emerges from the head of the femur at an obtuse angle, which ensures the mobility of the joint and uniform distribution of the load between the limbs. The trochanters are bony projections to which muscle tendons attach.
Fabrics and structures
The normal functioning of the joint is ensured by a variety of structures, each of which performs corresponding functions.
Blood supply, performance and decreased sensitivity of the joint are due to:
- Ligaments and tendons surround the joint on all sides, covering and protecting the femur and its neck, as well as the socket itself.
- Cartilage covers the head of the femur and part of the acetabulum.
- Subcartilaginous areas are bone tissue made up of cells and extracellular connective substance.
- The joint membrane or capsule is the source of a special secretion: synovial fluid to lubricate the parts of the joint.
- The acetabular labrum connects the edge of the acetabulum and the transverse ligament.
The hip joint receives nutrients through a fairly isolated network of vessels and arteries. The blood supply to the inner parts of the joint is provided by the acetabular branch of the obturator artery, and the surrounding capsules, ligaments and muscles are supplied through the deep arteries of the thigh and buttocks.
Anatomical formations located next to the hip joint.
Often the cause of pain in the hip joint is damage to the anatomical structures located next to it. These items include:
- Skin and subcutaneous tissue: the outer covering of the body.
- The muscles of the thigh, pelvis, lower back and glutes provide mobility to the joints and also strengthen them from the outside.
- Extra-articular ligaments: they perform a strengthening function and are found around the joint capsule.
- Periarticular bursae are bundles of connective tissue that prevent friction between soft and hard tissues.
Risk factor's
Inflammatory processes in the pelvic area occur due to mechanical damage or damage to certain types of bacteria. In this case, both the elements of the joint and the anatomical formations surrounding them can be exposed to pathological effects.
As a rule, one or more structures become inflamed:
- leather
- muscles
- ligaments (extra-articular, femoral heads)
- periarticular bags
- TBS capsule
- cartilage
- acetabular labrum
- subcartilaginous areas
Pain in the hip joint is often caused by harmful microorganisms that provoke the development of infectious arthritis. Other reasons are also common:
- immune system disorders
- Joint injuries due to excessive physical activity.
- old age
- metabolic disorders
- other diseases
Pain characteristics
When diagnosing hip pain, additional symptoms play an important role, which can indicate the root cause of the problem.
Pain in the hip joint and radiates to the leg.
If pain from a sore joint radiates to the groin, knees, or buttocks, the problem is most likely due to damage to the nerve that supplies the leg area due to one of the following reasons:
- joint tumor
- infectious arthritis – occurs due to damage caused by a pathogen
- fracture of the femur (in the head or neck area)
- Legg-Calvé-Perthes pathology: necrosis of the cartilage tissue of the femoral head
- Juvenile epiphysiolysis: alteration of the structure of the joint head and its inflammation.
Pain in the hip joint, radiating to the leg, may indicate pathologies of the cartilaginous tissue and periarticular structures, lack of lubrication of the joints and damage to the synovial membrane. Painful symptoms may appear suddenly or increase gradually.
Pain when walking
Pain in the hip joint can occur when walking if the acetabulum comes into contact with the cartilaginous tissue of the head of the femur, resulting in an inflammatory process. The cause of this phenomenon may be mechanical damage, inflammation of anatomical formations located next to the joint.
Depending on the intensity of the pain in the hip joint when walking, the root cause of the problem can be identified:
- discomfort that occurs at the beginning of walking and gradually disappears, a sign of inflammation of the periarticular bursa
- discomfort that gradually increases from the moment you start walking: inflammation of the articular surfaces of the hip joint
- continuous high-intensity pain, accompanied by deterioration in the functionality of the joint, occurs with dislocations and fractures
- The pain occurs closer to the night, a consequence of the deformation of the cartilage of the femoral head and (or) the acetabulum, which rub against each other and become inflamed.
- Pain of moderate intensity is a sign of minor injuries and bruises.
Pain when abducting the leg.
Pain when abducting the leg is caused by inflammation of the tissues and structures that provide movement: muscles, periarticular bursae, tendons. Similar symptoms often result from myositis (inflammation of muscle tissue), bursitis (inflammation of the periarticular bursa), and tendonitis (inflammation of the tendons).
Causes
In most cases, pain in the pelvic area is caused because the patient has one of the following problems:
- arthritis
- coxarthrosis
- trochanteric bursitis
- tendonitis
- infectious pathologies
- hereditary diseases
- tumor formation in the pelvic area
Without prompt treatment, each of these causes can lead to serious complications, including loss of joint mobility.
Arthritis
Arthritis (coxitis) is a disease of the joint tissue caused by disorders of the immune system or damage to pathogens - viruses and bacteria.
Arthritis symptoms:
- temperature rise
- pain and swelling in the joint area
- motor impairment
The disease occurs in acute, subacute and chronic forms.
coxarthrosis
Another name for coxarthrosis is osteoarthritis of the hip joint. This pathology is caused by metabolic disorders in cartilage tissues, which cause their death. The cause of this phenomenon may be injury, impaired blood supply, excessive physical activity, age over 45 years and heredity. The main symptom of coxarthrosis is pain in the lower back, groin and buttocks, which gradually increases during physical activity and causes lameness. Discomfort decreases during periods of inactivity.
Bursitis of the trochanteric bursa
The presence of an inflammatory process in the bursa (trochanteric bursa) is characterized by the appearance of intense pain in the joint area. Athletes and older people are susceptible to the disease. The main symptom of trochanteric bursitis is pain in the area of the greater trochanter, which increases when trying to lean on the affected leg.
tendonitis
Inflammation of the tendons is called tendonitis. This is a disease that occurs in acute or chronic forms and leads to degenerative changes in tissues. Often, pathology occurs in athletes who do not follow their running technique, as well as after heavy load on the hip muscles.
Typically, tendinitis is a complication of another disease:
- thyroid pathology
- metabolic disorders
- arthritis
- osteoarthritis
- Inflammatory process of systemic or infectious origin.
- hip dysplasia
Tendinitis causes the patient discomfort during movement, pain, changes in gait and clicking when walking in the joint area.
Infections
Some infectious diseases cause inflammation of the joint tissues, as well as nearby anatomical structures, resulting in severe pain in the hip joint. Most often, the following pathologies have similar symptoms:
- Aseptic necrosis of the femoral head is a disruption of the blood supply to the groin area, resulting in tissue death. The pain associated with this disease is sharp and intense. The problem is more common in men.
- Purulent arthritis is a serious disease that requires immediate treatment. If you do not seek medical help immediately, sepsis may occur. The associated symptoms are general intoxication, pain and swelling in the affected joint area and difficulty in motor activity.
- Tuberculous arthritis is common in children and is characterized by slow progression. The associated symptoms are increased fatigue, decreased motor activity and muscle atrophy. Pain of varying intensity increases when a purulent abscess occurs.
Infectious pathologies of the hip joint cause serious complications and therefore require immediate treatment.
Hereditary diseases
Hereditary pathologies of the hip joint usually appear between 1 and 10 years of age, and are characterized by pathological changes in the tissue of the glenoid cavity and/or the head of the femur. The most common inherited disease affecting the hip joint is Legg-Calvé-Perthes syndrome, which is characterized by pain and gait disturbances due to the death of cartilage tissue in the joint.
Bone and soft tissue tumors.
Benign or malignant growths of bone and soft tissue in the hip joint can cause pain when walking or at rest. The tumor can occur in bone tissues (osteomyelitis), cartilaginous tissues (chondroblastoma, chondroma), osteochondral tissues (osteochondroma). As a rule, neoplasms cause discomfort and are felt on palpation. Benign tumors are treated surgically, some of them can transform into cancerous tumors.
Soft tissue tumors of the thigh:
- lipoma
- rhabdomyoma
- fibroma
- hemangioma
- neuroma
An oncologist is involved in the diagnosis and treatment of tumors in the hips and pelvis.
To do
With serious pathologies of the hip joint, a person feels severe pain. Discomfort in the pelvic area is a reason to visit a medical center for examination and treatment.
Special attention should be paid to the intensity of the pain:
- Lungs- occur with bruising after injury. Cold should be applied to the painful area to reduce swelling. To reduce pain, it is recommended to take a non-steroidal anti-inflammatory drug. It is advisable to consult a doctor.
- Moderate- They usually appear in diseases of the hip joint, accompanied by difficulty in motor activity and increased body temperature. Discomfort increases during physical activity. It is necessary to consult a rheumatologist.
- Strong- arise due to dislocations and fractures. Accompanied by limitation or inability to perform physical activity. In cases of severe pain in the hip joint caused by an injury, it is advisable to go to an ambulance.
There are many popular recipes that are used for pain in the hip joint. It is important to remember that all of them are suitable for symptomatic treatment and pain reduction, but they will not help eliminate the cause of the problem. Effective treatment is carried out exclusively under the supervision of a qualified doctor.
Which doctor should I contact?
If you have hip joint pain, you should contact your GP or family doctor, who will refer you to a specialist. Diseases of the musculoskeletal system are treated:
- traumatologist— pain in the hip joint due to physical activity, sprains, falls and other injuries
- rheumatologist- sudden onset of joint pain for no apparent reason
You may also need to see other doctors: a surgeon, oncologist, infectious disease specialist, etc.
Diagnosis
The first important stage in the diagnosis of pain in the hip joint is an external examination, which necessarily includes anamnesis and palpation. Depending on the severity of the disease and the patient's complaints, laboratory tests and instrumental diagnostic methods are prescribed:
- bone scan- the use of x-rays to examine a specific area of the body
- Computed tomography and magnetic resonance imaging- modern and accurate diagnostic methods that allow you to obtain highly informative images of the joint and the area around it
- microbiological examination of a sample of biological materialallow detecting the presence of pathogenic microorganisms: viruses and bacteria
- immunological blood test- allows you to identify immunological disorders, determine the presence of certain autoantibodies
- arthroscopy (endoscopic examination)— probe examination, possibility of taking a sample of joint tissue for future research
- laboratory examination of the spill- take a sample of intra-articular fluid during puncture and identify the causative agent of an infectious disease in it, checking sterility
The combined use of several diagnostic methods allows us to identify the cause of pain in the hip joint with great precision.
Treatment
Treatment of pain in the hip joint should be prescribed by a doctor based on examination and diagnosis. As a rule, drug therapy or surgery is prescribed.
Medicine
Treatment of pain in the hip joint should be comprehensive, aimed at eliminating the symptoms and, most importantly, eliminating the cause of the problem. For this, pharmacotherapy is used, which includes the use of:
- non-steroidal anti-inflammatory drugs- help reduce pain, relieve swelling
- means to improve microcirculation- help restore blood circulation and nutrition of joint tissues
- chondroprotectors- promotes the restoration of cartilage tissue
- muscle relaxants- reduce pain, improve blood flow to the damaged area
- hormonal drugs- to relieve pain and suppress inflammation
In the treatment of pain in the hip joint, physiological procedures are very effective: massage, acupuncture, cryotherapy and laser therapy. Special therapeutic exercises and manual therapy are also used.
Surgical
Surgical intervention is indicated in advanced cases when conservative treatment does not help the patient. It involves the partial or complete replacement of the diseased joint with a prosthesis.
Prevention
Reducing the load on the legs will slow down pathological processes inside the joint, which is why obese people are recommended to start losing weight.
Preventive measures will help reduce pain in the hip joint:
- walk regularly
- physiotherapy
- a balanced diet rich in vitamins A, C, E
Timely consultation with a doctor in the early stages of the disease increases the effectiveness of treatment, and also reduces the risk of complications and serious consequences for the body.