Hip painPain with hip arthrosis | Hip Arthrosis

Hip painPain with hip arthrosis

If you are looking for the cause of your hip pain or you do not know exactly what is causing your hip pain, let us guide you through our hip pain diagnostics and arrive at the most likely diagnosis. If it is known that you suffer from hip arthrosis and you are in pain, we recommend our topic: Pain with hip arthrosis – What can I do?

Age

In cases where the cause of the hip joint arthrosis is unknown (= primary hip arthrosis), hip joint arthrosis usually does not develop until older age (malum coxae senile), i.e. usually after the age of 50 – 60. Often, the arthrosis includes both sides of the hip joint. Hip joint arthrosis, which is based on incompletely healed hip joint diseases or anatomical variants in the femoral head or acetabulum (= secondary hip arthrosis), usually occurs earlier and usually only affects one side of the hip joint. In medical terms, unilateral joint involvement is referred to as monoarticular.

Gender distribution

Since women suffer more frequently from hip dysplasia and the cartilage is less resilient than the male cartilage due to its nature, women are more prone to hip arthrosis than men.

  • Spine
  • Basin shovel (Os ilium)
  • Hip joint
  • Femoral head
  • Femoral neck
  • Symphysis
  • Small rolling mound (trochanter minor)
  • Greater trochanter major

Frequency

Since wear and tear as the trigger for hip arthrosis must ultimately be seen as the cause, it is not surprising that the risk of contracting hip joint arthrosis increases with age. Studies show that from the age of 70 years on, about 70 to 80 % of people show signs of wear on the hip and/or other joints. A significant risk factor for the development or acceleration of existing hip arthrosis is overweight (obesity).

Risk factors

Overweight: Being overweight has a worsening effect on the above-mentioned prearthrotic changes. Thus, the occurrence of hip arthrosis is increased as one of the consequences of overweight. If the hip joint is already affected by arthritis, being overweight usually increases pain.

Being overweight has a worsening effect, but is not an isolated cause and is therefore not the only cause of arthritis.

  • Incorrect loads, for example as a result of poorly positioned acetabular cups (hip dysplasia), unfavorable femoral neck angle (coxa valga antetorta), etc.
  • Endocrine factors (hormonally induced factors), e.g. a cortisone-producing tumor
  • Genetic influences, family history of hip arthrosis due to inherited hip dysplasia and cartilage quality
  • Acetabular cup
  • Femoral head
  • Femoral neck
  • Used joint gap

What should be examined to diagnose hip joint arthrosis? Clinical diagnostics: Apparative diagnostics:Necessary examinations: Useful examination in individual cases:

  • Assessment of range of motion and motion pain
  • Evaluation of the gait pattern
  • Leg length difference
  • Muscular atrophy
  • Evaluation of pressure painful points
  • Assessment of adjacent joints
  • Assessment of blood circulation, motor skills and sensitivity
  • X-ray image: pelvic overview image (BÜS)
  • X-ray image: axial-side image
  • X-ray: functional images and special projections
  • Sonography (ultrasound)
  • Computed tomography (CT)
  • MRI of the hip (magnetic resonance imagingNMR)
  • Scintigraphy
  • Clinical-chemical laboratory for differential diagnostics
  • Puncture with synovial analysis (fine tissue examination of the joint mucosa cells)

As a rule, osteoarthritis is limited to one or more joints, although in most cases it initially runs without symptoms for years.

Even if coxarthrosis, i.e. wear and tear of the hip joint, can be diagnosed on the X-ray image, pain or pain-related movement restrictions etc. are not necessarily present. Depending on the specific disease, the increasing destruction of the hip joint is the first priority.

The first tears in the joint cartilage appear, which increasingly expand and consequently cause an inflammation of the articular membrane (synovitis) due to small dying off cartilage abrasion particles. It is this inflammation that then causes sometimes very severe pain in the patient. Arthrosis alone is not painful!

The increasing pressure on the joint tries to reduce the same pressure by a larger joint surface. This leads to bone attachments. The consequences of the changes caused by destruction and deformation in the area of the acetabulum as well as capsule shrinkage and bone growth are reflected in a painful reduction in function. The x-ray image shows a depleted joint cartilage, which can be recognized by the absence of a joint space. The changes become particularly clear when compared with the X-ray image of a healthy hip (see above).