Arthritis of the Hip

Arthritis is one of the most common causes of pain in the hip. Arthritis is a progressive disorder, which means that it typically starts gradually and gets worse with time. The term arthritis literally means “inflammation of the joint.”

There are different types of arthritis that can affect the hip. The type of arthritis you have may affect your treatment options.

Types of Arthritis

There are five main types of arthritis that can affect the hip joint. They are:

  • Osteoarthritis
  • Rheumatoid arthritis
  • Ankylosing spondylitis
  • Systemic lupus erythematosus
  • Psoriatic arthritis

There is no cure for any type of arthritis, but there are ways to treat the pain and other associated symptoms.

Osteoarthritis

Osteoarthritis means “arthritis of the bone” and is the most common form of arthritis. It is often described as the result of wear and tear on the joints, which explains why it is more common in older than younger people.

The hip joint consists of the ball-shaped end of the thigh bone (femoral head) which fits into the hip socket (acetabular socket). The inside of this ball-and-socket joint is lined with smooth cartilage to help the joint move easily. If this smooth cartilage wears away, the remaining rough surfaces of the ball-and-socket grind against each other, causing pain. Over time, osteoarthritis can degenerate or permanently damage the joint.

Osteoarthritis of the hip (and other parts of the body) has been associated with the following:

  • Structural problems with the hip joint (hip dysplasia, femoroacetabular impingement)
  • Advancing age
  • Obesity
  • Previous damage or injury to the hip

However, osteoarthritis may develop in people without these risk factors.

Figure a

 

Figure b

Two radiographs of a female patient showing acetabular dysplasia (a shallow hip socket). The patient started to have hip pain when she was 20 years-old (a). This hip dysplasia was not treated and 15 years later she had end-stage osteoarthritis of the hip (b). Note the complete loss of cartilage joint space between the ball and the socket over this 15-year interval.

 

 

 

Arthritis Symptoms

Regardless of the type of arthritis, symptoms of hip arthritis include:

  • Pain in the hip joint that may include pain in the groin, outer thigh, or buttocks
  • Pain that is typically worse in the morning and lessens with activity
  • Difficulty walking or walking with a limp
  • Pain that worsens with vigorous or extended activity
  • Stiffness in the hip or limited range of motion

In patients with rheumatoid arthritis or lupus, fatigue and weakness may also occur. Arthritis often occurs in flares with remission, but some people experience a relatively stable level of pain without flares.

Any type of arthritis can involve more than one joint in the body, so a person with osteoarthritis of the hands may develop the condition in the hip as well. Rheumatoid arthritis and lupus typically affect both hips at the same time, while osteoarthritis and psoriatic arthritis may occur in one hip but not the other.

Diagnosis

If you suspect you may have arthritis of the hip, the most important first step is an accurate diagnosis. Dr. Clohisy and his colleagues are experts in arthritis of the hip. A diagnostic evaluation will likely include the following:

  • Your medical history, including where you experience pain and if you limp at times
  • A physical examination, in particular to see how well you can move the hip
  • Radiographs or X-rays to determine if there are any abnormalities in the joint
  • Blood tests to determine antibodies that may be associated with a specific type of arthritis (only if needed).

Treatment

Nonsurgical treatment of arthritis of the hip at Alimran Medical Center, we may recommend any of the following treatments

Physiotherapy

Chiropractic

Steroid injection

Ozone injection

Pulsed radiofrequency

Botox® injections

Acupuncture

Prolotherapy