Diseases of the musculoskeletal system in almost all cases are associated with dysfunction of his organs, which causes a lot of inconvenience to the patient.
An important symptom of musculoskeletal pathologies is pain. Joint injuries are particularly unpleasant.
The groin is the largest of them. The pain in case of its loss can be localized as around it and given to different anatomical structures: in the organs of the small pelvis, in the lower back or in the thighs.
General classification of causes
The etiology of hip pain is different.
In medicine, the following causes of arthralgia are distinguished by condition:
- Inflammatory and infectious processes within the joint and surrounding tissues.
- Degenerative diseases of the musculoskeletal system.
- Injuries.
- Bone and soft tissue neoplasms.
There are other specific causes of arthralgia:
- Piriformis Syndrome. Associated with her prolonged spasm.
- Necrosis of the femoral head (GBC). Most often it is a complication of another TBS pathology.
- Legg-Calve-Perthes disease. It is GBC osteochondropathy.
- Dissection of osteochondrosis. In various sources it can be called Koenig's disease.
- Diabetic osteoarthropathy. Complications of diabetes.
- Pseudogout. Also chondrocalcinosis.
- Intermittent hydraarthrosis is an overproduction of synovial fluid.
- Synovial chondromatosis (Lotsch syndrome).
Also, the foot in the hip joint area 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 dietary recommendations are not followed, a pregnant woman may develop calcium deficiency, due to this mineral imbalance, bone and joint structure is disturbed.
Causes of pain
The prevalence of arthralgia increases with age.In children, the symptoms of TBS (thigh joint) disease occur with a frequency of no more than 10%, and in the elderly - by 50%. Mostly women suffer from this pathology. This is due to age-related hormonal changes after menopause.
Why does the hip joint hurt? There is no correct answer to this question, as the list of reasons is quite long.
The main factors that cause arthralgia in the hip joint:
- Pathological process within the musculoskeletal system. Most often, this is a consequence of direct mechanical action: a bruising of the joint with subsequent inflammation of its components.
- Anatomical changes in the joints. 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 with pain of any localization. Metabolic disorders cause mineral imbalance. The bone-ligament bond 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 suffocation of the musculoskeletal joint.
Inflammation of the hip joint is classified into:
- primary. Formed by direct penetration of pathogens into the joints: a blow with a sharp object or sharp with the formation of a wound.
- Medium. TBS infection occurs from a distant focus of inflammation: by contact or by hematogenous route.
Arthritis TBS
It mostly appears in elderly patients.Painful pain in the thigh joint, aggravated by walking, radiates to the groin, perineum and thighs. It is difficult for the patient to get up from a chair or climb stairs without assistance. Worse discomfort in the morning.
Therapy involves taking anti-inflammatory drugs and inserting 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 inflammation of the synovium, cartilage and joint capsule. The reason is a malfunction of the immune system. Characterized by polyarthralgia, stiffness of movements in the morning, high temperature is possible.
The shoulder and hip joints are affected extremely rarely, the pain appears only in a late stage of RA after a few years from the onset of the disease.
Acute septic arthritis
It is an infectious disease of childhood, 70% of cases occur in infants under 4 years of age. The causative agent is usually Staphylococcus aureus. The child refuses to walk due to severe acute pain in the hip joint and groin when moving. It is characterized by high temperature and increased excitability.
Treatment includes removal of the leak from the ankle cavity and antibiotic therapy.
The risk of developing osteomyelitis and sepsis is high.
Tuberculous coccitis or arthritis
Most often, pediatricians face this disease. In young children, the immune system is poorly developed, which leads to the possibility of infection.
This disease is characterized by a slow progression. Initially, the child gets tired very quickly, his activity decreases, he stops running. Gradually, atrophy of the thigh muscles occurs. Movements are impeded. Pain in the hip joint in a child acquires a strong character of pain, the limb becomes longer than a healthy one.
If pus melts the synovial membrane, then the exudate spreads along the muscles and tendons, forming phlegmon and fistula.
In the absence of complications, conservative treatment is performed.
Tendovaginitis in the thigh joint area
This pathology is an inflammation of the muscle tendon and its vagina. Caused by prolonged overuse or foot injury.
Main complaints: the femoral joint hurts when moving, the lesion swells, the 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 frequently inflamed.It partially covers the femur. With bursitis of the hips, the pain radiates 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, then treatment consists of discharging the lower limbs with a cane or crutches.
Medications: Pain medications and corticosteroids.
Idiopathic ankylosing spondylitis
This is a chronic inflammation of the spine and elements of the sacroiliac joints.
The disease is dangerous for its complications that lower the standard of living and lead to disability.
If you find such a problem, you should immediately contact a specialist for the appointment of appropriate treatment.
The etiology is not entirely clear. Modern medicine suggests that the main cause is hereditary predisposition. Most often, people under 30 get sick.
Symptoms of idiopathic ankylosing spondylitis:
- Increased body temperature, fever.
- Intoxication syndrome: general malaise, weakness, lack of appetite, weight loss, sleep disturbance.
- Persistent dull pain in the hip joint, as well as at the level of the sacrum and buttocks, spreading along the back of the thigh. Usually bilateral, at night their intensity increases.
- Limited mobility in the lower back and hips. This symptom gradually passes to the upper parts of the spine along the entire back, including the neck. As a result, the patient assumes a forced "seeker position".
Rehabilitation therapy is based on special physiotherapy exercises for joint development.
Medications: NSAIDs for pain relief and inflammation, corticosteroids.
Tendonitis
Athletes or people whose work is associated with strenuous physical work are prone to tendon inflammation. Feature of manifestation: painful pain in the hip joint occurs with a large load on it. At rest, discomfort is usually not noticed.
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 last stage of the disease the bones and joints are affected. Chewing gum formation is characteristic. Excessive pathological mineralization occurs. TBS is extremely rare.
Gumma - a nodule in the tissue, formed during advanced syphilis, destroying the surrounding tissue. The process ends with the formation of severe wounds.
Treatment is ineffective, the risk of developing complications in the form of osteomyelitis is high.
Fungal arthritis of the thigh
Occurs as a result of prolonged use of antibiotics and with pathology of the immune system.
People who are infected with HIV or have AIDS are particularly susceptible to fungal arthritis.
Joint pain is constantly present, it has a aching character.
Fungal bone lesions are characterized by a tendency for fistula formation, duration, and difficulty of treatment.
Therapy: systemic antifungals.
According to the indications, the surgical intervention is performed.
Bone and soft tissue tumors
Oncological diseases of the hip joint can be metastases of cancer of a distant organ or arise independently.
- Benign tumors of bone tissue - osteoma.
Foreign formation to the body increases, squeezing nerves and blood vessels. The clinic is similar to piriformis syndrome.
- Malignant bone tumors - osteosarcoma.
The neoplasm grows rapidly in size, necrotic, and disintegrates, spreading metastases throughout the body.Pain in the hip joints at night is unbearable, they do not stop even after taking NSAIDs or trying anesthesia.
- Mesenchymal tumors form from soft tissues. Benign ones are rarely recurrent and do not metastasize. Depending on the aggressiveness of the malignant cells, the intensity of the pain is variable.
Degenerative joint diseases
Coxarthrosis
Osteoarthritis of the thigh is a chronic disease characterized by a change in the integrity of articular surfaces, due to violation of metabolic processes. It develops very slowly, over several years. Cartilage tissue is affected first, then bone tissue, followed by deformity of the ankle and limb varus. Occurs at the age of 40 years.
Symptoms:
- The hip joint only hurts when you walk.
- Stiffness of movements in TBS.
- As the process progresses, a shortening of the length of the limbs is noticed.
- Weakness and atrophy of muscle mass.
- Çalimi.
- When you walk, a crackle is heard.
- With a bilateral lesion, a "duck walk" occurs - being transferred from one foot to the other.
Medications: NSAIDs, vasodilators, muscle relaxants, chondroprotectors, injections of hormonal drugs into the ankle cavity.
Local effects: ointments, creams, compresses.
In the final 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 thigh and thigh joint.
- It is sudden, sharp and sharp. It starts in the waist and buttocks region, descends to the back of the leg.
- Unilateral localization of pain is more common.
- The patient assumes a forced position - lying on a healthy side.
- Possibly reducing the sensitivity of the skin of the foot.
The treatment is complex. Anti-inflammatory and analgesic, moderate physical activity (swimming), physiotherapy after reducing the most acute phenomena.
With severe pain, it is recommended to do an anesthetic blockade.
INJURY
Injury
Pain of moderate intensity is characteristic, during active movements its intensity increases. The first time after a thigh joint injury, lameness appears, which passes quickly.
At rest, the symptoms disappear.
To quickly get rid of the pain in case of a pelvic joint injury, it is necessary to apply cold to the injury site: an ice pack or a frozen product.
hip dislocation
Probably:
- Congenital. It is the result of unsuccessful birth or intrauterine developmental pathologies. The child has uneven gluteal folds and shortening of the limbs, possibly a suppressed nerve, manifested by convulsions. If the dislocation is not corrected in infancy, then later the child may become disabled.
- Traumatic. Signs: severe back pain, complete closure of joint function, massive edema and extensive hematoma appear over the affected area. Getting up from a chair or bed becomes impossible for the patient without assistance.
In case of hip dislocation, you should go to the emergency room or hospital immediately.
FRACTURE
The hip joint is formed by strong strong bones.
The most common diagnosis from this subgroup is a surgical neck fracture. It is given mainly to women after 60 years.
The cause of such an injury is a drop or blow to the TBS area.
The strongest pain is felt, the hip joint is pulled and abscesses, movement in it is almost impossible. The upper thigh area swells, a large hematoma appears. The injured leg is shortened, the patient lame. During the movement, a characteristic click is heard.
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 suppressed, you may experience a feeling of numbness in the thigh.
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. A long-term spasmodic piriformis muscle presses on the sciatic nerve and its vessels, causing a number of symptoms:
- Leg pain in the hip joint region. It runs to the buttocks and lumbosacral joint.
- Increased discomfort when leaning on the affected leg.
- Piriformis muscle compression.
- Sudden "lumbago" pain along the nerve.
Etiology: infectious and inflammatory injuries and diseases of the pelvic organs, vertebrogenic pathologies, muscle overtraining, long-term maintenance of an abnormal posture.
Medications: NSAIDs, muscle relaxants, analgesics, blood circulation improvers, glucocorticoids.
After the onset of acute phenomena, rehabilitation measures can be prescribed: physiotherapy, massage, acupuncture.
Aseptic necrosis of the femoral head
The vast majority occurs in young people. The etiology of the disease is ischemia of the upper thigh. With insufficient blood supply to the tissues, their oxygen starvation occurs and their necrosis (necrosis) begins.
Clinical appearance: thigh joint hurts and gives leg and perineum. Leaning on the injured leg is not possible. 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 rapidly developing osteomyelitis and sepsis is high.
Treatment is surgery and drug therapy.
Koenig's disease
Dissecting osteochondritis - the exfoliation of a small necrotic cartilage area from the bone and its extension into the articular cavity.
This is a rare disease. Typical for men 15-35 years old.
Patients complain of mild excruciating pain in the hip joint. The connection "sticks" when moving.
Treatment is conservative (duration 10-18 months) and surgical. During the surgical intervention, the exfoliated masses are removed, the congruence (comparability) of the articular surfaces is restored.
Diabetic osteoarthropathy
Violation of glucose metabolism leads to circulatory disorders and innervation of all organs. Changes in the hip joint are more often unilateral: on the right, it occurs more often than on the left. The immune response is reduced, which makes it easier for the body to infect.
Clinical appearance:
- Swelling of the wrist.
- The skin on it is cool 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.
pseudoguti
This pathology is the deposition of calcium salts in the articular cartilage.
Doctors associate it with endocrine pathology: hyperparathyroidism, diabetes, gout, etc.
Symptoms:
- Starting with acute pain in the hip joint.
Several types of calcium salts are known. With some of them (pyrophosphates), there is no pain.
- Movement in it is limited, grabbing the leg sideways is difficult.
- Edema and hyperemia are characteristic.
- Increased body temperature and fever.
To date, there is no specific treatment. The acute attack is stopped by intra-articular administration of corticosteroids and NSAIDs.
Intermittent hydrarthrosis
It is a chronic disease, manifested by periods of increased production of synovial fluid. prone to frequent recurrences.
It is mainly diagnosed in women 20-40 years old.
The etiology is unknown. There are two theories for the occurrence of this disease: injury-related and caused by endocrine disorders.
The bond increases in size, becomes rigid.
The attacks pass 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 articular surface varies, as well as its properties.
The chance of being affected by chondromatosis is much higher in men, mainly middle-aged and older.
The etiology is unclear.
There is local swelling, limited joint function, cracking during work, arthralgia.
Treatment is surgical only.
Low back pain in children and adolescents
epiphysis
This pathology is most typical for children during puberty (from 11 to 16 years old). At this time, there is a sharp rising jump. Due to the weak growth zone, the HBA slips on the neck, which results in discomfort at the hip joint.
The child feels pain in the thigh, passing to the groin and knee. Lame is noticed, but the support in the limb is preserved.
The disorder is surgically corrected. You should start therapy as soon as possible. Alternatively, HBA slippage can cause the development of osteoarthritis and inflammation of the joints.
Dysplasia
It is an excess formation of connective tissue that can replace bone elements. As a result, solid anatomical structures become plastic, flexible. Ligaments, menisci and tendons weaken. An unstable hip is formed, which is distinguished by frequent dislocations.
Dysplasia is an inherited disease that usually appears in infants from 3 months to 1 year. Orthopedists can easily afford correction of foot placement.
The latent form can appear in adolescence.
If you notice manifestations of plantar fasciitis or deformity of the foot in a child, then you should immediately go to the hospital for an examination of the baby's musculoskeletal system!
The later dysplasia is detected, the more problematic its treatment.
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 rapid growth.
An adult should initially determine the location and nature of the pain, contact a pediatrician, and obtain the information needed to prevent complications from developing.
Legg-Calve-Perthes disease
The syndrome is characterized by HBK necrosis in children under 15 years of age. The right thigh joint is most often affected.
The cause of the pathological condition is a violation of blood circulation in the upper leg with the addition of cartilage tissue in the process.
Clinical appearance:
- Initially the femoral head aches. As the necrosis progresses, the arthralgia suddenly disappears. This indicates the death of receptors in sensitive organs.
- Change in gait - the baby begins to limp.
- Movement on TBS is limited.
- Most often one-sided.
Complications: dislocation, coxarthrosis, deformity of the lower limbs, muscle atrophy.
Diagnostic measures
Before prescribing treatment, the doctor should carefully study the complaints, medical history, and perform an examination.
In case of hip joint disease, the following studies are needed:
- Laboratory blood tests (with inflammation, ESR increases and leukocytosis is observed).
- Plain radiograph of the wrist in two or more projections.
- MRI with or without contrast.
- MSCT. Used to control the presence of a sarcoma.
- Osteoscintigraphy. Radionuclide method. The most common and informative type of bone tissue examination.
- Hip ultrasound.
- Densitometry. Required to determine bone density and strength.
If the patient can not sit or stand, and it is useless to relieve the pain, then he is immediately sent to the hospital for further surgical treatment.
When to see a doctor urgently
- When there is a sharp pain when moving to the hip joint.
- If it is impossible to support the affected leg.
- Detection of edema of the lumbar and femoral region.
- Redness or bruising on the affected area.
There are popular ways to relieve pain in the pelvic joint. It's not worth relying on these tips for a quick cure. Without a thorough diagnosis, it is impossible to determine the cause of arthralgia and self-medication will lead to the development of complications.