Degeneration of the joints is often referred to as arthritis. The degeneration occurs when the smooth covering (cartilage) at the end surfaces of the bones wears away. The most common type of arthritis is “osteoarthritis” which is caused by wear and tear of the cartilage. In some cases, the degradation is caused when the lining of the joint becomes inflamed as part of an underlying systemic disease. These conditions are referred to as inflammatory arthritis.
The most common types of inflammatory arthritic conditions of the hip include:
- Rheumatoid Arthritis: systemic disease of the immune system commonly affects multiple joints on both sides of the body at the same time
- Ankylosing Spondylitis: chronic inflammatory disease of the spine and the sacroiliac joints (junction where the spine meets the pelvic bone)
- Systemic Lupus Erythematosus (SLE): an autoimmune disease in which the body’s immune system attacks its own healthy cells and tissues
The typical symptom of arthritis is joint pain. Inflammatory hip arthritis is mainly characterized by an aching pain in the groin region, outer thighs or buttocks. The pain is commonly most severe in the morning which sometimes lessens with activity during the course of the day. Vigorous activities may result in increased pain and stiffness and limit your movement making walking difficult.
Hip arthritis can be diagnosed by a combination of physical examination and imaging. Your doctor will ask you to move your hip in different directions to find out which motions are restricted or painful. X-rays and laboratory tests may be ordered to diagnose or rule out inflammatory conditions. X-rays may show thinning or erosion in the bones or loss in joint space. Laboratory studies will show the presence of a rheumatoid factor or other antibodies.
The treatment options vary depending on the diagnosis.
- Anti-inflammatory medications or corticosteroids may help reduce the inflammation and pain.
- Physical therapy may be recommended to help you increase the range of motion and strengthening exercises to maintain muscle tone
- Assistive devices such as canes or walkers can make your daily living activities easier
Surgery is considered the last treatment resort when the above non-surgical treatment options fail to reduce the symptoms. The type of surgery to be performed depends on your age, condition of the hip joint, and the type and progression of the inflammatory disease. The goal of the surgery is to relieve pain and improve the joint motion. The most common surgical procedures include:
- Total hip replacement: Indicated for patients with rheumatoid arthritis and ankylosing spondylitis.