Arthritis of the hip joint or coxarthrosis - symptoms, diagnosis, treatment
Coxarthrosis is a chronic disease manifested by damage to the hip joint, starting from the articular cartilage and ending with its ligamentous apparatus. This pathology, once it occurs, does not disappear, gradually progressing and leading to permanent disability of the patient.
Causes of coxarthrosis
There is no reliable information about the causes of primary arthrosis. In medical circles, it is believed that the disease occurs as a result of excessive mechanical loads on the articular cartilage, as well as due to a hereditary predisposition, when the cartilage is unable to withstand mechanical influences.
Secondary arthrosis develops when the articular cartilage has already been changed due to various reasons - injuries, infections, systemic, endocrine diseases, etc.
Degrees of coxarthrosis
All over the world, the classification of any form of arthrosis is accepted, based on the results of an X-ray examination of the corresponding joint. It was created in 1957 by Kellgren and Lawrence, and in 1987 it was adapted as a result of expanding the possibilities of X-ray diagnostics. According to it, there are 5 degrees of coxarthrosis:
- degree 0 - complete absence of any changes on the X-ray;
- 1st degree — bony growths (osteophytes) along the edge of the joint, which cannot be interpreted as arthrosis;
- 2nd degree – pronounced osteophytes, the size of the joint gap has not changed;
- 3rd degree – pronounced osteophytes, the size of the joint space is moderately reduced;
- 4th degree – pronounced osteophytes, the joint gap is sharply narrowed, sclerotic changes under the articular cartilage (bone compaction) are noted.
Symptoms of coxarthrosis and its diagnosis
The main symptom of any form of arthrosis is pain in the affected joint. Pain sensations occur:
- with mechanical stress on the joint, they intensify in the evening and subside with physical rest and during sleep;
- with the first steps of the patient, they quickly subside, and then gradually increase during the day when the load on the joint continues.
In addition, this pathology is characterized by "blockage" pain caused by a piece of dead cartilage ("joint mouse") getting between the articular surfaces. The pain is sharp and disappears only when the "mouse" is moved. Movement in the joint may be blocked.
In severe cases, there is crepitation (crunch) in the joint, deformation and compaction, limitation of joint mobility, lameness, atrophy of the thigh muscles, postural disturbances, gait changes, up to the appearance of a "duck" gait.
The diagnosis of coxarthrosis is made in the presence of several signs:
- pain in the joint area for 2 weeks or more. On the X-ray, osteophytes and narrowing of the joint space, in the blood test, ESR is normal;
- decreasing external rotation of the hip. At the same time, there is short-term morning stiffness in the joint (less than an hour) and pain during internal rotation.
If these signs are detected and the symptoms described above are present, the diagnosis of coxarthrosis can be considered reliable.
Treatment of coxarthrosis
In order to avoid coxarthrosis without surgery or to delay its implementation as much as possible, the specialist pursues several goals in the treatment process:
- teach the patient to treat the joint with care (avoid prolonged standing, squatting, jumping, etc.);
- decrease in pain intensity;
- teaching physical exercises aimed at preserving joint function;
- improvement of the condition of the hip joint;
- prevention of further destruction of joint surfaces.
To do this, you should switch to a healthy lifestyle with weight loss to normal (recommended diets with reduced calories) and dosed physical activity under the guidance of a physical therapy doctor. It is also justified to use a cane from the side opposite to the affected joint.
Non-steroidal anti-inflammatory drugs are widely used among medicinal products, which significantly reduce pain - paracetamol, nimesulide, diclofenac, meloxicam, etc. Given the lack of evidence of the effectiveness of chondroprotectors based on chondroitin and glucosamine, their use in coarthrosis is not justified.
Operations for coxarthrosis are indicated only in the case of a significant reduction in the patient's quality of life, his disability and severe pain syndrome. The main and most radical intervention is joint endoprosthesis. During the operation, part of the pelvic and femur bones that form the joint are removed, and a metal prosthesis is placed in their place. The result of such an operation is quite positive, and the prognosis after it is very favorable - people return to normal life, after a rather difficult period of rehabilitation.
Unfortunately, with coxarthrosis, endoprosthetic surgery is not always feasible. Therefore, prevention of the disease and prevention of its progression are always in the first place. And for this, the website Dobrobut.com recommends, at a minimum, to reduce weight and protect the affected joint.
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