Swollen stump with arthrosis of the hip joint
Osteoarthritis of the hip joint (medical name deforming osteoarthritis) is a degenerative and dystrophic disease of the musculoskeletal system.
It consists in the gradual destruction of cartilage with the growth of bone tissue, which leads to the formation of bone synostosis, completely limiting the mobility of the joint.
In some cases, because of bone osteophytes, reactive arthritis develops, which can easily be confused with rheumatoid arthritis. This explains the diagnostic errors.
The prevalence of the disease is 5-10%,and it increases with increasing age of a person. However, at present, this disease is found not only in elderly patients, but also in young people.
The relevance of arthrosis of the hip joint is due to the fact that in the absence of treatment after 10 years, a persistent impairment of joint mobility, leading to disability of the person, develops.
Causes of arthrosis of the hip joint
From the point of view of causal factors, thisthe disease must be classified into primary arthrosis and secondary. With the primary changes develop on the unchanged cartilage as opposed to the secondary. The main predisposing factors that increase the likelihood of developing hip arthrosis are the following:
- increased stress on joints as occupational hazard
- infringement of cartilage innervation
- disturbance of microcirculation in cartilaginous tissue
- metabolic disorders that lead to the accumulation in the joints of various chemicals that gradually destroy it
- autoimmune processes in the body, destroying cartilage
- long walking
- hypermobility of joints, etc.
Symptoms of arthrosis of the hip joint
The main symptoms that are typical for deforming arthrosis of the hip joint are manifested in the following:
- 1) Pain arising from prolonged stress on the joint, for example, as a result of a long walk. These pains peaked in the evening and become insignificant at rest and during sleep
- 2) Pain of the "starting" character. They are manifested by painful sensations arising at the beginning of the movement, but gradually they decrease after several movements
- 3) Blockade pain or periodic seizurein the joint. It is associated with the presence of an articular mouse - pieces of necrotic cartilage, which falls between the articular surfaces. When the movement results in the removal of this piece, the pain is stopped
- 4) Crunch in the joint
- 5) Joint deformation, which is associated with bone growths
- 6) The pronounced restriction of mobility in the joint -first, the rotation of the femur to the inside and its retraction is disturbed, then the thigh rotates outward and its reduction, the bending and extension of the hip joint lastly suffers
- 7) Lame on the aching leg, and if the pathological process is bilateral, it leads to a duck walk (the patient is shifted from foot to foot)
- 8) The curvature of the spine gradually develops (the posture is disrupted)
- 9) First the pains appear in the groin area, and then gradually irradiate into the knee
- 10) Atrophic changes in the thigh and gluteus muscles
- 11) Over time, the flexural position of the limb develops, leading to its shortening.
- redness of the joint
- its defoguration - a change in shape due to inflammatory edema
- local skin temperature increase above the hip joint
- permanent pain in the joint.
Diagnosis of arthrosis of the hip joint
Diagnostic search for suspecteddeforming arthrosis of the hip joint is primarily to conduct its radiographic examination. The main signs confirming the diagnosis are the following:
- narrowing of the gap between the articular surfaces of bones
- the appearance of osteophytes - bone growths
- gradual flattening of the femoral head
- calcification of the soft tissues that surround the joint.
In the second stage, there is a narrowing of the jointslits with more pronounced osteosclerosis. In the third stage, all these changes progress - the marginal osteophytes become large, the articulation gap can be traced slightly.
It is almost completely absent in the fourthstage of the disease, the epiphyseal ends of the bones have a sharply altered shape. In addition to X-ray studies, the following studies should be included in the diagnostic program:
- general clinical blood test, in which deviations are not determined
- biochemical blood test, which reveals an increase in seromucoid, fibrinogen and sialic acids only in the development of reactive synovitis
- general clinical urine analysis unchanged
- synovial biopsy and histological examination
- puncture of the joint and obtaining synovial fluid with its subsequent cytological examination
- biopsy of cartilaginous tissue and its histological study.
The main complication that develops against the backdrop of a steady progression of coxarthrosis. is the immobility of the patient with bilateral hip joint damage.
Against this background, a person can not independentlymove, and becomes disabled. And in the case of prolonged immobilization, the probability of hypostatic pneumonia increases dramatically, which has a high percentage of deaths.
Treatment of arthrosis of the hip joint
Treatment of deforming arthrosis of the hip joint pursues such goals as:
- 1) Slowing down the progression of the pathological process
- 2) Reduction of pain syndrome
- 3) Treatment of developed synovitis
- 4) The maximum possible restoration of joint function.
- the appointment of drugs that improve the recovery of cartilage tissue (chondroprotectors)
- use of drugs that have anti-inflammatory properties (non-steroidal anti-inflammatory drugs or corticosteroids)
- use of drugs that improve microcirculation in the cartilaginous tissue and subchondral bone
- use of physiotherapy techniques
- massage and exercise therapy, which prevent the development of muscle atrophy.
At the initial stages, the use ofspecial fixing bandages, which limit the load on the joint and prevent additional traumatization of the cartilage. If the disease is more advanced, then the use of orthopedic walking sticks and crutches is shown to unload the patient's joint.
In some cases, one has to resort tooperative intervention. Modern orthopedics has a large arsenal of artificial joints, which allow a sufficient volume to restore the function of the broken hip joint.
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