Orthopedics-Online

Inflammation of the hip

Synonyms

Coxitis, trochanteric bursitis, coxitis fugax, activated osteoarthritis

definition

A inflammation the hip often develops in the hip joint, and can depend on the typical signs of inflammation how Pain, swelling, fever and general malaise be accompanied.

frequency

The infectious inflammation of the hip occurs approximately two to ten times in 100,000 patients and is most commonly caused by Spread of germs through the bloodstream or through open injuries or surgery at the hip joint.

Classification

In the case of a hip joint infection, between one infectious and one not infectious Inflammation can be distinguished.

The infectious is through bacteria provoked, while the non-infectious often one rheumatic disease or one arthrosis underlying.
In the activated osteoarthritis, one degenerative disease, leads worn bone material or cartilage in the joint space to an inflammatory reaction.

With both variants, those affected have strong pain and take one Relieving posture a.
A volatile hip ignition (Coxitis fugax), which is also often called "Runny nose“And is classified as a non-infectious hip joint inflammation, can occur in children aged five to eight years about two to three weeks after a respiratory infection occurrence.

For children, a Femoral head necrosis, which are also called Perthes disease known to occur and the cause of which is still unknown.
Perthes disease occurs at the age of four to ten years on, and can be a serious disorder of the hip function have as a consequence.

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Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
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The hip joint is one of the joints that are exposed to the greatest stress.
The treatment of the hip (e.g. hip arthrosis, hip impingement, etc.) therefore requires a lot of experience.
I treat all hip diseases with a focus on conservative methods.
The aim of any treatment is treatment without surgery.
Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

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causes

In the case of infectious inflammation, bacteria are carried into the joint and trigger an inflammatory reaction.
The bacteria are often Staphylococci or Streptococciwhich can travel to the joint through the bloodstream from other points of inflammation in the body.
Such a spread of germs can, for example, from infectious diseases such as tuberculosis, gonorrhea (sexually transmitted disease; also as Gonorrhea called) or syphilis (also a sexually transmitted disease). The bacteria can also get into 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 abraded parts of the joint cartilage trigger an inflammatory reaction in the joint fluid and lead to the classic signs of inflammation such as swelling, overheating and particularly severe pain.

People with gout can also develop inflammation in the joint. Gout is a metabolic disease. The uric acid produced by degradation processes increasingly accumulates in the blood. Since that 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 underlying diseases that can also cause hip joint inflammation are hyperfunction of the parathyroid gland (Hyperparathyroidism), Underactive thyroid (Hypothyroidism) and Wilson's disease (copper storage disease).

The causes of hip necrosis in children are still largely unknown, but an underlying coagulation disorder is suspected. The blood supply is prevented, so that ultimately an insufficient supply of the femoral head leads to the death of the tissue.

An incorrect running posture can also lead to inflammation in the hip. More precisely, in this case, periosteum inflammation can develop on the hip. For more information, the editors recommend the following article: Inflammation of the periosteum of the hip

Symptoms

In the case of infectious inflammation of the hip joint it causes inflammation strong painthat typically radiate into the groin.
They are considered very by patients uncomfortable and pulling described.

Because of the severe pain, the affected person often takes one Relieving posture a. He rotates the leg leioutward and keeps it in easy bent position.
In this way, the pain is often relieved and full stress is usually no longer possible. Typically, the condition also leads to one pathological Gait pattern.
In order to relieve the hips when walking, the upper body may be used inclined to the healthy side, and weight shifted to the working leg.

In addition to the general signs of inflammation also occur fever, Exhaustion and Reduction in performance on.
The affected person feels weak, tired and uncomfortable.

In children, the inflammation in the hip joint (Coxitis fugax) often become purulent. The Collection of pus in the joint space then practice one enormous pressure on the not yet as stable joint as in an adult.
This can result in a Dislocation of the joint (dislocation) or for Insufficient supply of the cartilaginous parts of the joint.

Children are not yet able to precisely state the pain. They are often unspecific and are usually referred to as Pain in the knee joint specified. It is noticeable with the children limping gait, movement is often restricted and painful. Especially those rotation (Rotation of the leg in hip joint) causes complaints.

Here is one Treatment urgently needed, as otherwise it can also lead to damage to the growth plates, and this possibly during the growth of the child Favor malpositions.

Hip necrosis (Perthes disease) shows similar symptoms.

diagnosis

The diagnosis generally includes an examination of the blood first.

Speaking of an increase in C-reactive protein (CRP), a protein that is increased in the blood during the acute phase of inflammation, and an increase in white blood cells (Leukocytes) for inflammation in the body.
The rate of erosion of blood cells (ESR) is also increased.

A puncture may be necessary to determine the pathogen: After the skin over the hip joint has been thoroughly disinfected, the doctor inserts a thin hollow needle, too Trocar called, into the joint space, and sucks in some liquid with a syringe attached to it.
This sample can be examined for bacteria in the microbiological laboratory.

This determination is particularly important for the subsequent treatment with antibiotics, since the various bacteria are killed by the drugs to different degrees.

Using an X-ray or, in some cases, computed tomography or magnetic resonance imaging of the hip (also MRI of the hip) to better visualize the soft tissues, the exact localization of the inflammatory focus can be determined and the extent to which an appropriate therapy can be initiated.

In the case of childhood hip joint inflammation (coxitis fugax), the further diagnosis includes an ultrasound examination (Sonography). In children, the structures can still be displayed very well, while X-rays are inconspicuous in this case. An effusion in the joint can be seen in sonography.

Differential diagnostic should be from the Coxitis fugax, hip rhinitis in children, hip necrosis of unknown cause (Perthes disease) should be differentiated. This form of inflammation can be differentiated from hip rhinitis using X-rays and ultrasound.

therapy

With a infectious inflammation of the hip will this timely after determining the pathogen with corresponding antibiotic treated.

During one inpatient treatment this treatment takes place in the hospital mostly intravenously by means of infusions for several dayswhat the advantage of the antibiotic gets into the blood system faster, and the inflammation often subsides more quickly.
But one Taking tablets is also possible.

In addition, the Treatment of Symptoms required. The patient can additionally pain reliever drugs such as Ibuprofen receive.

He should also do that Relieve and protect the joint. This also helps relieve pain.

If drug and conservative treatment is unsuccessful and the inflammation does not decrease, a surgery become necessary. In this operation the Focus of inflammation eliminated and removed the ignited material. A will then remain in the surgical wound for several days drainagewhich continues to drain fluid from the inflammatory area and thus a sprouting again of inflammation prevented.