Inflammation of the hip

Coxitis, bursitis trochanterica, coxitis fugax, activated arthrosis

Definition

Inflammation of the hip often develops in the hip joint and can be accompanied by the typical signs of inflammation such as pain, swelling, fever and general malaise.

Frequency

Infectious inflammation of the hip occurs approximately two to ten times in 100,000 patients and is most frequently caused by the carry-over of germs through the bloodstream or by open injuries or operations on the hip joint.

Classification

In hip joint inflammation, a distinction can be made between infectious and non-infectious inflammation. Infectious is caused by bacteria, while non-infectious inflammation is often caused by rheumatic disease or arthrosis. In activated arthrosis, a degenerative disease, abraded bone material or cartilage in the joint space leads to an inflammatory reaction.

In both variants, the affected person suffers severe pain and adopts a relieving posture. A transient hip inflammation (coxitis fugax), also often referred to as “hip rhinitis”, which is a non-infectious inflammation of the hip joint, can occur in children aged five to eight years about two to three weeks after a respiratory infection. Children may also suffer from necrosis of the femoral head, also known as Perthes disease, the cause of which is still unknown. Perthes disease occurs at the age of four to ten years, and can cause a serious disruption in the function of the hip.

Causes

In infectious inflammation, bacteria are carried into the joint and trigger an inflammatory reaction. The bacteria are often staphylococci or streptococci, which can enter the joint through the bloodstream from other inflammation sites in the body. Such germ transfer can be caused by infectious diseases such as tuberculosis, gonorrhea (sexually transmitted disease; also known as gonorrhea) or syphilis (also a sexually transmitted disease).

The bacteria can also enter the hip joint through surgery, joint puncture or open bone fractures. In the case of non-infectious inflammation, activated osteoarthritis can be the cause. Small rubbed-off parts of the joint cartilage trigger an inflammatory reaction in the joint fluid, leading to the classic signs of inflammation such as swelling, overheating and particularly severe pain.

People who suffer from gout can also develop inflammation in the joint. Gout is a metabolic disease. The uric acid produced by degradation processes accumulates more and more in the blood.

Since the solubility product in the blood is finally exceeded and the uric acid cannot be sufficiently removed from the system, uric acid crystals precipitate, especially in the joint space. These deposits can then cause inflammation. Other basic diseases that can cause inflammation of the hip joint are hyperparathyroidism, hypothyroidism and Wilson’s disease (copper storage disease). The causes of infantile hip necrosis are still largely unknown, but an underlying coagulation disorder is suspected. This prevents the blood supply, so that ultimately a reduced supply to the femoral head leads to the death of the tissue.