Hip Arthritis

Description

Hip arthritis is also known as degenerative arthritis or osteoarthritis of the hip. It is most frequently seen in those beyond 45 years of age. The primary mechanism involves the gradual breakdown of the cartilage that serves as a cushion for the joint.

Causes

The most common cause of arthritis of the hip is wear and tear over time. Family history can contribute. However, in many cases, there is no genetic component. Early developmental irregularities can predispose some patients. Trauma and fractures can potentiate hip arthritis as well. Obesity is also a risk factor and hip arthritis is more common in women.

Symptoms

The most common symptom is pain in the groin area, towards the front, not the side of the hip. The pain is worse with weight bearing, often causing patients to limp. Activities such as crouching, crossing the legs and putting on socks and shoes become difficult.

Diagnosis

The physician will assess the mobility and strength of the hip during the physical exam. Patients are asked to walk and get up from a seated position. The lower back and legs are examined as well. The nerve and vascular supply to the leg on the side of the arthritis is assessed also as it may affect the course of treatment. Routine X-rays are the standard diagnostic imaging modality in evaluating hip arthritis. CT scans, MRIs and bone scans may be performed, but usually are not necessary.

Management

Conservative treatment involves over-the-counter pain medications, exercise and physical therapy. Physical therapy can help strengthen the muscles surrounding the hip joint, increasing flexibility and reducing pain.

Steroid injections can help if more conservative therapy fails. These injections can be performed by an interventional pain management physician under X-ray guidance to accurately target the hip joint.

If hip arthritis continues to worsen despite these measures, surgical options include hip replacement. This is a major surgical procedure and should be performed only as a last resort.