Diseases of the musculoskeletal system in almost all cases are accompanied by dysfunction of its organs, which causes the patient a lot of discomfort.
An important symptom of pathologies of the musculoskeletal system is pain. Joint injuries are especially unpleasant.
The hip is the largest of them. In case of defeat, the pain can be localized around it, as well as to various anatomical structures: the small pelvis, lower back or thighs.
General classification of causes
The etiology of hip pain is different.
In medicine, the following causes of arthralgia are conditionally different:
- Inflammatory and infectious processes in the joint and surrounding tissues.
- Degenerative diseases of the musculoskeletal system.
- Neoplasms of bones and soft tissues.
There are additional specific causes of arthralgia:
- Piriformis syndrome. It is associated with prolonged spasms.
- Necrosis of the femoral head (GBC). Often, this is a complication of another pathology of TBS.
- Legg-Calve-Perthes disease. It is osteochondropathy of the GBC.
- Disintegration of osteochondrosis. In various sources it can be called Koenig's disease.
- Diabetic osteoarthropathy. Complications of diabetes.
- Pseudoqut. Also chondrocalcinosis.
- Intermittent hydarthritis is an overproduction of synovial fluid.
- Synovial chondromatosis (Lotsch syndrome).
Also, pregnant women often have leg pain in the hip joint.
During this period, complex hormonal changes occur, the growing uterus compresses the neighboring organs and tightens the ligamentous apparatus of the hip joint. In addition, weight gain increases the load on the legs. When dietary recommendations are not followed, a pregnant woman may develop calcium deficiency, which disrupts the structure of bones and joints due to this mineral imbalance.
Causes of pain
The prevalence of arthralgia increases with age.Symptoms of TBS (hip joint) in children do not exceed 10%, and in adults - 50%. Most women suffer from this pathology. This is due to age-related hormonal changes after menopause.
Why does the thigh joint hurt? There is no clear answer to this question, because the list of reasons is quite long.
The main factors that cause arthralgia in the hip joint:
- Pathological process inside the musculoskeletal system. Often this is the result of a direct mechanical action: a bruise with subsequent inflammation of its components.
- Anatomical changes in the joint. They can be congenital or post-traumatic (dislocations, fractures).
- Pathology of other systems. Inflammation of the MT (small pelvis) organs can spread to the pelvic bones. Neurological disorders manifest themselves with pain of any localization. Metabolic disorders cause mineral imbalances. Bone-ligament weakens, the risk of injury increases.
Inflammatory and infectious processes in the joints and surrounding tissues
The most common cause of arthralgia of any localization is inflammation of the musculoskeletal system.
Inflammation of the hip joint is divided into:
- Initial. It is formed by the penetration of pathogens directly into the joint: a blow with a sharp or blunt object with the formation of a wound.
- Secondary. TBS infection occurs from a distant source of inflammation: by contact or by hematogenous means.
It occurs in most elderly patients.Pain in the hip joint, intensified by walking, spreads to the groin, perineum and thighs. It is difficult for the patient to get up from a chair or climb stairs without help. Anxiety worsens in the morning.
Therapy involves the administration of anti-inflammatory drugs and the introduction of glucocorticoids into the intraarticular bursa. If necessary, its cavity is emptied.
Rheumatoid arthritis (RA)
It is a chronic systemic connective tissue disease similar to polyarthritis.The essence of this pathological process is inflammation of the synovium, cartilage and joint capsule. The reason is dysfunction of the immune system. It is characterized by polyarthralgia, stiffness of morning movements, high fever is possible.
The shoulder and hip joints are very rarely affected, and the pain only appears in the late stages of RA a few years after the onset of the disease.
Acute septic arthritis
It is an infectious childhood disease, 70% of which occurs in infants under 4 years of age. The causative agent is usually Staphylococcus aureus. The child refuses to walk because of severe pain in the hip joint and groin while moving. It is characterized by high fever and increased excitement.
Treatment includes removal of the effusion from the joint cavity and antibiotic therapy.
The risk of developing osteomyelitis and sepsis is high.
Tuberculosis coccyx or arthritis
Pediatricians often encounter this disease. In young children, the immune system is poorly developed, which leads to the possibility of infection.
The disease is characterized by slow development. At first, the child gets tired very quickly, activity decreases, he stops running. Gradual atrophy of the thigh muscles occurs. Movements are blocked. In children, pain in the hip joint takes on a very painful character, the limb lasts longer than a healthy one.
When the synovial membrane of the pus dissolves, the exudate spreads along the muscles and tendons, forming phlegmon and fistulas.
In the absence of complications, conservative treatment is carried out.
Tendovaginitis in the hip joint
It is an inflammation of the pathological muscle tendon and its vagina. Occurs as a result of long-term overuse or damage to the foot.
The main complaints: pain in the hip joint when moving, swelling of the lesion, changes in gait - lameness.
Treatment - medication: anti-inflammatory drugs, intraarticular injections of corticosteroids.
Of all the synovial sacs, the acetabular bursa is the most inflamed.Partially covers the femur. In hip bursitis, the pain spreads to the thigh and gluteal region. The patient is unable to lie on the affected side: the pressure in the synovial sac increases and the pain intensifies.
If there are no complications with bursitis, treatment consists of loosening the lower extremities with a cane or armpit.
Medications: Analgesics and corticosteroids.
Idiopathic ankylosing spondylitis
It is a chronic inflammation of the elements of the spine and sacroiliac joints.
The 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 determine the correct treatment.
The etiology is not clear. Modern medicine shows that the main reason is hereditary predisposition. People under the age of 30 often get sick.
Symptoms of idiopathic ankylosing spondylitis:
- Increased body temperature, fever.
- Intoxication syndrome: general malaise, weakness, loss of appetite, weight loss, sleep disturbances.
- Constant dull pain in the hip joint, as well as at the level of the sacrum and hip, spreads along the back of the thigh. Usually bilateral, their intensity increases at night.
- Limited mobility in the waist and hips. This symptom gradually spreads to the upper parts of the spine along the entire back, including the neck. As a result, the patient is forced to take the "applicant's pose. "
Rehabilitation therapy is based on special physiotherapy exercises for joint development.
Medications: NSAIDs, corticosteroids to relieve pain and inflammation.
Athletes or people whose work involves heavy physical work are prone to tendonitis. Characteristics of the manifestation: aching pain in the hip joint, occurs with a large load. Anxiety is usually not observed at rest.
To reduce the load on the foot, in advanced cases - bed rest is recommended.
Drug treatment: NSAIDs, topical analgesics, glucocorticosteroids, chondroprotectors.
In the late stages of the disease, the bones and joints are affected. The formation of chewing gum is characteristic. Their excessive pathological mineralization occurs. TBS is extremely rare.
Gumma - a nodule in the tissues, formed during advanced syphilis, destroying the 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 arthritis of the hip
Occurs as a result of long-term use of antibiotics and pathologies of the immune system.
People living with HIV or AIDS are especially susceptible to fungal arthritis.
Pain in the joint is constant, painful in nature.
Fungal lesions of the bones are characterized by a tendency to form fistulas, the duration and difficulty of treatment.
Therapy: systemic antifungals.
Surgery is performed according to the instructions.
Tumors of bones and soft tissues
Oncological diseases of the hip joint can be metastases of cancer of a distant organ or can occur independently.
- Benign tumors of bone tissue - osteomas.
The formation, which is foreign to the body, grows, compresses the nerves and blood vessels. The clinic is similar to piriformis syndrome.
- Malignant bone tumors - osteosarcomas.
The neoplasm grows rapidly, necrotic and disintegrates, and metastases spread throughout the body.Pain in the hip joints is unbearable at night, they do not stop even after taking NSAIDs or trying to anesthetize.
- Mesenchymal tumors are formed by soft tissues. Benign ones are rarely recurrent and do not metastasize. The intensity of pain varies depending on the aggressiveness of the malignant cells.
Degenerative diseases of the joints
Hip osteoarthritis is a chronic disease characterized by changes in the integrity of the articular surfaces due to disruption of metabolic processes. It grows very slowly, over several years. First the cartilage tissue, then the bone tissue, then the joint and the surrounding varus deformity are affected. It happens at the age of 40.
- The hip joint only hurts when walking.
- Stiffness of movements in TBS.
- As the process progresses, the length of the joint is shortened.
- Weakness and atrophy of muscle mass.
- There is a crackling sound as you walk.
- With a bilateral lesion, a "duck walk" occurs - passing from one foot to another.
Medications: NSAIDs, vasodilators, muscle relaxants, chondroprotectors, injection of hormonal drugs into the joint cavity.
Local effects: ointments, lotions, compresses.
Surgery is performed in the last stage of the disease.
Degenerative changes in the intervertebral discs cause damage to the surrounding tissues.
- Pain in the lumbar region, which spreads to the hip and thigh joints.
- Sudden, sharp and sharp. It starts in the waist and hips, descends to the back of the foot.
- Unilateral localization of pain is more common.
- The patient takes a forced position - lying on the healthy side.
- Probably a decrease in the sensitivity of the skin of the foot.
The treatment is complex. Anti-inflammatory drugs and analgesics, moderate physical activity (swimming), physiotherapy after the elimination of the most acute events.
With severe pain, anesthetic blockade is recommended.
Pain is characteristic of moderate intensity, its intensity increases during active movements. For the first time after an injury to the hip joint, a disability appears, which passes quickly.
Symptoms disappear at rest.
In order to quickly get rid of the pain during a pelvic joint injury, it is necessary to apply a cold to the injured area: ice pack or frozen product.
- birthIt is the result of unsuccessful birth or intrauterine developmental pathologies. The child has uneven gluteal folds and shortening of the joint, probably a compressed nerve, manifested by convulsions. If the dislocation is not corrected in infancy, the child may become disabled later.
- Traumatic. Signs: severe pain over the affected area, complete cessation of joint function, massive edema and extensive hematoma. It is impossible to get up from a chair or bed without the help of a patient.
In case of hip dislocation, you should immediately go to the emergency room or hospital.
The hip joint is made up of very strong bones.
The most common diagnosis from this subgroup is a surgical neck fracture of the femur. It is mainly applied to women after the age of 60.
The cause of such damage is a drop or impact in the area of TBS.
The strongest pain is felt, the hip joint is pulled and there is an abscess, it is almost impossible to move inside. The area of the upper thigh is swollen, a large hematoma is visible. The injured leg is shortened, the patient is lame. A characteristic click is heard while moving.
When a fracture occurs, the surrounding tissues are damaged, which is accompanied by a burning sensation. If left untreated, an inflammatory process can begin here. If the nerve is constricted, the Buddha may feel numb.
Treatment is complex: surgical and medical.
Specific causes of arthralgia
The surrounding tissues are also affected by the localization of pathological processes in the hip joint. Long-term spasmodic piriformis muscle squeezes the sciatic nerve and its arteries, causing a number of symptoms:
- Pain in the leg in the region of the hip joint. He goes to the hip and lumbosacral joint.
- Increased anxiety while relying on the affected leg.
- Compression of the piriformis muscle.
- Sudden pain along the nerve "lumbago".
Etiology: pelvic injuries and infectious and inflammatory diseases, vertebrogenic pathologies, muscle overload, long-term maintenance of non-physiological posture.
Medications: NSAIDs, muscle relaxants, analgesics, circulatory drugs, glucocorticoids.
Rehabilitation measures can be prescribed after the reduction of acute events: physiotherapy, massage, acupuncture.
Aseptic necrosis of the femoral head
The vast majority occur in young men. The etiology of the disease is ischemia of the upper thigh. When there is not enough blood supply to the tissues, their oxygen starvation occurs and their necrosis (necrosis) begins.
Clinical picture: pain in the hip joint and gives the foot and perineum. It is impossible to rely on an injured leg. After a few days, the nerve endings melt and the pain disappears. This is a terrible sign! There is a high risk of rapid development of osteomyelitis and sepsis with necrosis of deeper layers of bone.
Treatment is surgery and medication.
Dissecting osteochondritis is the erosion of a small necrotic cartilage from the bone into the joint cavity.
This is a rare disease. It is typical for men aged 15-35.
Patients complain of mild pain in the hip joint. It "sticks" when moving together.
Treatment is conservative (duration 10-18 months) and surgical. During the surgical procedure, the worn masses are removed, and the compatibility of the articular surfaces is restored.
Disruption of glucose metabolism leads to disruption of blood circulation and innervation of all organs. Changes in the hip joint are more often unilateral: more frequent on the right, on the left. The immune response is reduced, which makes it easier for the body to become infected.
- Swelling of the joint.
- The skin on it is cold to the touch.
There is no pain syndrome in diabetic osteoarthropathy!
Treatment consists of careful monitoring of blood glucose levels and timely administration of insulin.
This pathology is the deposition of calcium salts in articular cartilage.
Doctors associate it with endocrine pathologies: hyperparathyroidism, diabetes, gout, etc.
- It starts with sharp pain in the hip joint.
Several types of calcium salts are known. With some (pyrophosphates) there is no pain.
- The movement inside is limited, it is difficult to move the foot to the side.
- Edema and hyperemia are characteristic.
- Increased body temperature and fever.
To date, there is no specific treatment. An acute attack is stopped by intraarticular administration of corticosteroids and NSAIDs.
It is a chronic disease characterized by increased production of synovial fluid. often prone to recurrence.
It is diagnosed mainly in women aged 20-40.
The etiology is unknown. There are two theories of the disease: injury-related and endocrine disorders.
It grows in size and hardens together.
Attacks occur spontaneously within 3-5 days.
Medical treatment is ineffective. Relapses also occur after surgery.
This benign metaplastic disease is the replacement of synovial collagen with cartilage. The structure and characteristics of the articular surface vary.
Most middle-aged and older men are more likely to develop chondromatosis.
The etiology is unclear.
There is local swelling, limited joint function, wheezing during work, arthralgia.
Treatment is performed only surgically.
Hip pain in children and adolescents
This pathology is most characteristic of children during adolescence (11 to 16 years). At this time, there is a sharp jump in growth. Due to the weak growth zone, the HBA slides along the neck, which results in discomfort in the hip joint.
The child feels pain in the thigh, groin and knees. Lameness is noted, but the limb is relied on.
The disease is corrected surgically. You should start therapy as early as possible. Otherwise, sliding HBA can lead to the development of osteoarthritis and inflammation of the joints.
This is an excessive formation of connective tissue that can replace bone elements. As a result, solid anatomical structures become plastic and flexible. The ligaments, menisci and tendons weaken. An unstable hip is often formed, characterized by dislocation.
Dysplasia is an inherited disease and usually occurs in infants aged 3 months to 1 year. Orthopedists can easily cope with the adjustment of the foot.
The latent form can manifest itself during adolescence.
If you see a child with a deformity of the left leg or foot, you should go to the hospital as soon as possible to examine the baby's musculoskeletal system!
The later dysplasia is detected, the more problematic its treatment.
This group of diseases includes lesions of bone and cartilage tissue, the most loaded areas undergo aseptic necrosis.
Etiology: genetic predisposition, hormonal imbalances and infections can cause this pathology.
In 30% of cases, the hip joint is affected. These are mainly childhood diseases that occur in adolescents during growth.
An adult should initially determine the location and nature of the pain, contact a pediatrician, and obtain the necessary information to prevent the development of complications.
The syndrome is characterized by HBK necrosis in children under 15 years of age. The right thigh joint is more affected.
The cause of the pathological condition is a violation of blood circulation in the upper part of the foot with the addition of cartilage tissue to the process.
- First, there is a headache in the femur. With the development of necrosis, arthralgia suddenly disappears. This indicates the death of sensitive organ receptors.
- Change in gait - the child begins to stumble.
- Movement on TBS is limited.
- Often one-sided.
Complications: dislocation, coxarthrosis, deformity of the lower extremities, muscle atrophy.
Before prescribing treatment, the doctor should carefully study and examine the complaints, medical history.
In the case of hip joint disease, the following studies are needed:
- Laboratory blood tests (ESR increases with inflammation and leukocytosis is noted).
- Straight radiography of the joint in two or more projections.
- Contrast or non-contrast MRI.
- MSCT. Used to check for sarcoma.
- Osteosyntigraphy. radionuclide method. The most common and informative type of bone tissue examination.
- Ultrasound of the hip joint.
- Densitometry. Required to determine bone density and strength.
If the patient is unable to sit or stand and it is useless to relieve the pain, he is immediately sent to the hospital for further surgical treatment.
When to see a doctor urgently
- When there is severe pain when moving the hip joint.
- If it is not possible to support the affected leg.
- Detection of edema of the lower back and thighs.
- Redness or bruising in the affected area.
There are folk remedies to relieve pelvic joint pain. You do not need to rely on these tips to recover quickly. Without a thorough diagnosis, it is impossible to determine the cause of arthralgia, and self-medication will lead to the development of complications.