Diseases of the musculoskeletal system in almost all cases are accompanied by dysfunction of its organs, which causes many inconveniences to the patient.
An important symptom of pathologies of the musculoskeletal system is pain. Joint injuries are especially unpleasant.
The thigh is the largest of them. The pain in case of its defeat can be localized both around it and give it to various anatomical structures: the organs of the pelvis, lower back or thigh.
General classification of causes
The etiology of hip pain is diverse.
In medicine, the following causes of arthralgia are conditionally distinguished:
- Inflammatory and infectious processes inside the joint and its surrounding tissues.
- Degenerative diseases of the musculoskeletal system.
- Injuries.
- Neoplasms of bone and soft tissue.
There are additional specific causes of arthralgia:
- Piriformis syndrome. Associated with her prolonged spasm.
- Femoral head necrosis (GBC). Most often it is a complication of another pathology of TBS.
- Legg-Calve-Perthes disease. It is an osteochondropathy of the GBC.
- Dissection of osteochondrosis. In various sources it can be called Koenig's disease.
- Diabetic osteoarthropathy. Complications of diabetes.
- Pseudogout. Also chondrocalcinosis.
- Intermittent hydrarthrosis is an overproduction of synovial fluid.
- Synovial chondromatosis (Lotsch syndrome).
Also, the leg in the hip joint in pregnant women often hurts.
During this period, complex hormonal changes occur, the growing uterus displaces neighboring organs and strains the ligament apparatus of the hip joint. In addition, weight gain increases the load on the legs. If you do not follow the dietary recommendations, a pregnant woman may develop a lack of calcium, due to this mineral imbalance disrupts the structure of bones and joints.
Causes of pain
The prevalence of arthralgia increases with age.In children, the symptoms of TBS disease (hip joint) occur with a frequency of not more than 10%, and in the elderly - from 50%. Most often women suffer from this pathology. This is due to age-related hormonal changes after menopause.
Why does the hip hurt? There is no definite answer to this question, as the list of reasons is quite long.
The main factors causing arthralgia in the hip joint:
- Pathological process inside the musculoskeletal system. Most often this is a consequence of direct mechanical action: bruising of the joint with subsequent inflammation of its components.
- Anatomical changes in the joint. They can be congenital or post-traumatic (sprains, fractures).
- Pathology of other systems. Inflammation of the organs of the MT (small pelvis) can spread to the pelvic bones. Neurological disorders are manifested by pain of any location. Metabolic disorders cause mineral imbalance. The ligament ligament weakens, the risk of injury increases.
Inflammatory and infectious processes in the joints and surrounding tissues
The most common cause of arthralgia at any site is suppuration of the musculoskeletal system.
Inflammation of the hip joint is classified into:
- Basic. It is formed by direct penetration of pathogens into the joint: a blow with a sharp or blunt object with the formation of a wound.
- Second. TBS infection arises from a distant source of inflammation: by contact or by hematogenous route.
Arthritis TBS
It is most common in elderly patients.Painful pain in the hip joint, intensified when walking, radiates to the groin, perineum and thigh. It is difficult for the patient to get up from a chair or to climb stairs without assistance. The discomfort worsens in the morning.
Therapy involves taking anti-inflammatory drugs and introducing glucocorticoids into the intra-articular bursa. 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 the inflammation of the synovium, cartilage and joint capsule. The reason is dysfunction of the immune system. It is characterized by polyarthralgia, stiffness in the morning, high fever is possible.
Shoulder and hip joints are extremely rarely affected, the pain appears only in the late stage of RA after a few years from the onset of the disease.
Acute septic arthritis
It is an infectious childhood disease, 70% of cases occur in babies under 4 years. The causative agent is usually Staphylococcus aureus. The child refuses to walk due to severe sharp pain in the hip joint and groin when moving. It is characterized by high temperature and increased excitability.
Treatment includes removal of the effusion from the joint cavity and antibiotic therapy.
The risk of developing osteomyelitis and sepsis is high.
Tuberculous coccyx or arthritis
Pediatricians are most often faced with this disease. In young children, the immune system is underdeveloped, leading to the possibility of infection.
This disease is characterized by slow progression. Initially, the child gets tired very quickly, his activity decreases, he stops running. Gradually atrophy of the muscles of the thighs occurs. Movements are difficult. The pain in the hip joint in a child acquires an intense painful character, the limb becomes longer than the healthy one.
If the pus melts the synovial membrane, then the exudate spreads to the muscles and tendons, forming phlegmon and fistulas.
In the absence of complications, conservative treatment is performed.
Tendovaginitis in the hip joint
This pathology is inflammation of the tendon of the muscle and its vagina. Caused by prolonged overuse or leg injury.
The main complaints: the hip joint hurts when moving, the lesion swells, change in gait - lameness becomes noticeable.
Treatment - medication: anti-inflammatory drugs, intra-articular injections of corticosteroids.
bursitis
Of all the synovial sacs, the acetabular bursa is the most commonly inflamed.Partially covers the femur. In hip bursitis, the pain radiates to the thigh and gluteal area. The patient cannot lie on the affected side: the pressure in the synovial sac increases and the pain intensifies.
If there are no complications of bursitis, then treatment consists of unloading the lower limb with a cane or crutch.
Medicines: painkillers and corticosteroids.
Idiopathic ankylosing spondylitis
This is a chronic inflammation of the spine and the elements of the sacroiliac joints.
The disease is dangerous with its complications, which reduce the standard of living and lead to disability.
If you find such a problem, you should immediately contact a specialist to prescribe the right treatment.
The etiology is not entirely clear. Modern medicine suggests that the leading cause is hereditary predisposition. People under the age of 30 are most often ill.
Symptoms of idiopathic ankylosing spondylitis:
- Fever, fever.
- Intoxication syndrome: malaise, weakness, loss of appetite, weight loss, sleep disturbance.
- Constant dull pain in the hip joint, as well as at the level of the sacrum and buttocks, spreading to the back of the thigh. Usually bilaterally, at night their intensity increases.
- Limited mobility in the lower back and thighs. This symptom gradually spreads to the upper parts of the spine throughout the back, including the neck. As a result, the patient assumes a forced "petitioner's posture. "
Rehabilitation therapy is based on special physiotherapeutic exercises for joint development.
Medications: NSAIDs to relieve pain and inflammation, corticosteroids.
Tendinitis
Athletes or people whose work involves strenuous physical labor are prone to tendonitis. Characteristic of the manifestation: painful pain in the hip joint occurs with a heavy load on it. No discomfort is usually observed at rest.
It is recommended to reduce the load on the legs, in advanced cases - bed rest.
Drug treatment: NSAIDs, topical analgesic gels, glucocorticosteroids, chondroprotectors.
syphilis
In the late stages of the disease, bones and joints are affected. The formation of gum is characteristic. Their excessive pathological mineralization occurs. TBS is extremely rare.
Rubber - 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 joint
It occurs as a result of long-term use of antibiotics and in pathologies of the immune system.
People who are infected with HIV or have AIDS are particularly susceptible to fungal arthritis.
The pain in the joint is constant, it is painful.
Fungal bone lesions are characterized by a tendency to form fistulas, duration and difficulty of treatment.
Therapy: systemic antifungals.
According to the indications, surgery is performed.
Tumors of the bones and soft tissues
Hip cancer can be a metastasis of cancer to a distant organ or it can occur on its own.
- Benign tumors of the bone tissue - osteomas.
The formation, foreign to the body, grows, squeezing the nerves and blood vessels. The clinic is similar to piriformis syndrome.
- Malignant bone tumors - osteosarcomas.
The neoplasm rapidly grows in size, necrotizes and disintegrates, spreading metastases throughout the body. The pain in the hip joints at night is unbearable, they do not stop even after taking NSAIDs or an attempt at anesthesia.
- Mesenchymal tumors are formed by soft tissues. Benign ones are rare and do not metastasize. Depending on the aggressiveness of the malignant cells, the intensity of the pain is variable.
Degenerative diseases of the joints
Coxarthrosis
Osteoarthritis of the hip joint is a chronic disease characterized by a change in the integrity of the joint surfaces due to a violation of metabolic processes. It develops very slowly, over several years. Initially, cartilage tissue is affected, then bone tissue, followed by varus deformity of the joint and limb. Occurs at the age of 40 years.
symptoms:
- The hip joint hurts only when walking.
- Stiffness of movements in TBS.
- As the process progresses, there is a shortening of the length of the limb.
- Weakness and atrophy of muscle mass.
- Lameness.
- A crunch is heard while walking.
- In bilateral lesions, "duck gait" occurs - transfer from one leg to another.
Drugs: NSAIDs, vasodilators, muscle relaxants, chondroprotectors, injections of hormonal drugs into the joint cavity.
Local effects: ointments, lotions, compresses.
In the last stage of the disease, surgery is underway.
Osteochondrosis
Degenerative changes in the intervertebral discs cause damage to surrounding tissues.
symptoms:
- Pain in the lower back, radiating to the hip and thigh.
- It is sudden, sharp and sharp. It starts from the lumbar region and the buttocks, descends down the back of the leg.
- Unilateral localization of pain is more common.
- The patient is in a forced position - lying on his healthy side.
- Probably reduced sensitivity of the skin of the feet.
The treatment is complex. Anti-inflammatory and analgesics, moderate physical activity (swimming), physiotherapy after the disappearance of the most acute phenomena.
In case of severe pain, it is recommended to perform an anesthetic block.
Injuries
injury
It is characterized by pain of moderate intensity, with active movements its intensity increases. The first time after an injury to the hip joint, lameness appears, which passes quickly.
At rest, the symptoms disappear.
To quickly get rid of the pain in case of pelvic joint injury, it is necessary to apply cold to the site of injury: an ice pack or frozen product.
dislocation of the hip joint
Perhaps:
- Congenital. This is the result of a failed birth or pathologies of intrauterine development. The child has uneven gluteal folds and shortening of the limb, possibly pinched nerve, which manifests itself with convulsions. If the dislocation is not corrected in early childhood, the child may later become disabled.
- Traumatic. Signs: acute severe pain, complete exclusion of joint function, massive edema and extensive hematoma appear above the affected area. Getting out of a chair or bed becomes impossible for the patient without help.
In case of hip dislocation, you should immediately go to the emergency department or hospital.
fractures
The hip joint is formed by powerful healthy bones.
The most common diagnosis in this subgroup is a fracture of the surgical neck of the femur. It is used mainly for women after 60 years.
The cause of such damage is a fall or impact in the TBS area.
The strongest pain is felt, pulls the hip joint and abscesses, movement in it is almost impossible. The upper part of the thighs swells, an extensive hematoma appears. The injured leg is shortened, the patient is lame. A characteristic click is heard when moving.
When a fracture occurs, the surrounding tissues are damaged, which is accompanied by a burning sensation. In the absence of treatment, an inflammatory process can begin here. If the nerve is compressed, you may experience a tingling sensation in the thigh.
The treatment is complex: surgical and medical.
Specific causes of arthralgia
Piriformis syndrome
With the localization of pathological processes in the area of the hip joint, the surrounding tissues are also affected. Long-term spasmodic piriform muscle compresses the sciatic nerve and its vessels, causing a number of symptoms:
- Leg pain in the hip area. It goes to the buttocks and the lumbosacral joint.
- Increased discomfort when reading the affected leg.
- Thickening of the piriformis muscle.
- Sudden lumbago pain along the nerve.
Etiology: injuries and infectious and inflammatory diseases of the pelvic organs, vertebrogenic pathologies, muscle overtraining, long-term preservation of non-physiological posture.
Drugs: NSAIDs, muscle relaxants, analgesics, circulatory enhancers, glucocorticoids.
After the disappearance of the acute phenomena, rehabilitation measures can be prescribed: physiotherapy, massage, acupuncture.
Aseptic necrosis of the femoral head
The majority are found in young men. The etiology of the disease is ischemia of the upper thigh. In case of insufficient blood supply to the tissues, their oxygen starvation occurs and their necrosis (necrosis) begins.
Clinical picture: the hip joint hurts and gives the legs and perineum. It is not possible to read the injured leg. After a few days, the nerve endings melt and the pain disappears. This is a terrible sign! With necrosis of the deeper layers of bone, the risk of developing osteomyelitis and sepsis is high.
The treatment is surgical and drug therapy.
Koenig's disease
Dissecting osteochondritis - exfoliation of a small necrotic cartilage area of the bone and its protrusion in the joint cavity.
This is a rare disease. Typical for men aged 15-35 years.
Patients complain of mild painful pain in the hip joint. The joint "sticks" when moving.
The treatment is conservative (duration 10-18 months) and surgical. During surgery, the exfoliated masses are removed, the congruence (comparability) of the joint surfaces is restored.
Diabetic osteoarthropathy
Disruption of glucose metabolism leads to circulatory disorders and innervation of all organs. Changes in the hip joint are more often unilateral: on the right they occur more often than on the left. The immune response is reduced, which makes it easier to infect the body.
Clinical picture:
- Swelling of the joint.
- The skin above it is cold to the touch.
There is no pain syndrome in diabetic osteoarthropathy!
Treatment consists of careful monitoring of blood sugar levels and timely administration of insulin.
pseudogout
This pathology is the deposition of calcium salts in the articular cartilage.
Doctors associate it with endocrine pathologies: hyperparathyroidism, diabetes, gout and others.
symptoms:
- It starts with sharp pain in the hip joint.
Several types of calcium salts are known. Some of them (pyrophosphates) have no pain.
- Movement in it is limited, abduction of the legs is difficult.
- Swelling and hyperemia are typical.
- Fever and fever.
To date, there is no specific treatment. The acute attack is stopped by intra-articular administration of corticosteroids and NSAIDs.
Periodic hydratrosis
It is a chronic disease that manifests itself with bouts of increased production of synovial fluid. predisposed to frequent relapses.
It is diagnosed mainly in women aged 20-40 years.
The etiology is unknown. There are two theories about the origin of this disease: related to injuries and caused by endocrine disorders.
The joint increases in size, becomes hard.
The attacks go away on their own in 3-5 days.
Medical treatment is ineffective. Recurrences occur even after surgery.
Synovial chondromatosis
This benign metaplastic disease is the replacement of synovial collagen with cartilage. The structure of the joint surface changes, as well as its properties.
The chance of chondromatosis is much higher in men, mostly middle-aged and older.
The etiology is unclear.
There is local swelling, limited joint function, crunch during its operation, arthralgia.
The treatment is only surgical.
Hip pain in children and adolescents
epiphyseolysis
This pathology is most common in children during puberty (11 to 16 years). At this time there is a sharp jump in growth. Due to the weak growth zone, HBA slides on the neck, leading to discomfort in the hip joint.
The child feels pain in the thigh, passing into the groin and knee. Lameness is noticeable, but the support of the limb is preserved.
The disorder is corrected surgically. You should start treatment as early as possible. Otherwise, slipping HBA can cause osteoarthritis and joint inflammation.
Dysplasia
This is excessive formation of connective tissue that can replace bone elements. As a result, rigid anatomical structures become plastic, flexible. The ligaments, menisci and tendons become weak. An unstable thigh is formed, which is characterized by frequent dislocations.
Dysplasia is an inherited disease that usually occurs in infants from 3 months to 1 year. Orthopedists can easily handle the correction of the adjustment of the legs.
The latent form can manifest in adolescence.
If you notice signs of strabismus or deformity of the foot in a child, then you should quickly go to the hospital to examine the musculoskeletal system of the baby!
The later dysplasia is detected, the more problematic its treatment is.
Osteochondropathy
This group of diseases includes lesions of bone and cartilage tissue in which the busiest areas undergo aseptic necrosis.
Etiology: genetic predisposition, hormonal imbalance and infections can provoke this pathology.
In 30% of cases, the hip joint is affected. These are mostly childhood diseases that are common in adolescents during growth spurt.
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.
Legg-Calve-Perthes disease
The syndrome is characterized by HBK necrosis in children under 15 years of age. The right hip joint is more often affected.
The cause of the pathological condition is a violation of blood circulation in the upper leg with the addition of cartilage to the process.
Clinical picture:
- Initially, the femoral head hurts. As the necrosis progresses, the arthralgia suddenly disappears. This indicates the death of sensitive receptors on organs.
- Change in gait - the child begins to limp.
- Traffic on TBS is limited.
- Most often unilaterally.
Complications: dislocation, coxarthrosis, deformity of the lower limb, muscle atrophy.
Diagnostic measures
Before prescribing treatment, the doctor should carefully examine the complaints, medical history and conduct an examination.
In the case of hip disease, the following tests are required:
- Laboratory blood tests (inflammation increases ESR and leukocytosis is noted).
- Simple radiography of the joint in two or more projections.
- MRI with or without contrast.
- MSCT. Used to check for sarcoma.
- Osteoscintigraphy. radionuclide method. The most common and informative type of bone examination.
- Hip ultrasound.
- Densitometry. Needed to determine bone density and strength.
If the patient cannot sit or stand and is useless to relieve the pain, he is immediately sent to a hospital for further surgical treatment.
When to urgently go to the doctor
- When there is acute pain when moving in the hip joint.
- If it is impossible to maintain the affected leg.
- Detection of lumbar and femoral edema.
- Redness or bruising in the affected area.
There are folk ways to relieve pelvic pain. Reading these quick cure tips is not worth it. Without a thorough diagnosis, it is impossible to determine the cause of arthralgia, and self-medication will lead to complications.