hip osteoarthritis
Introduction
Introduction to hip osteoarthritis Hip osteoarthritis is inflammation of the joints caused by certain degenerative changes in the hip joint and cartilage softening. Hip osteoarthritis is one of the common diseases in orthopedics. It is characterized by degeneration of articular cartilage and new bone formation under the cartilage and around the joints. Hip osteoarthritis can be divided into two types, primary and secondary. In addition to osteoarthritis, the name of the disease is also called hypertrophic arthritis, proliferative arthritis, senile arthritis, degenerative arthritis, osteoarthrosis and the like. However, it is still said that most people with hip osteoarthritis. With the increase of age, the aging of connective tissue, the natural course of disease can not be reversed, but through treatment, can relieve symptoms, improve the range of activities, enhance joint stability, and delay the process. basic knowledge The proportion of illness: 0.003% Susceptible people: no specific population Mode of infection: non-infectious Complications: osteonecrosis
Cause
Causes of hip osteoarthritis
Primary factor (30%):
The primary lesion of hip osteoarthritis is the degeneration of hyaline cartilage, cartilage softening, erosion, etc., secondary to changes in the synovium, joint capsule and muscle.
Secondary factors (30%):
The causes of secondary osteoarthritis are: congenital anomalies of the joints, trauma, acquired irregularities of the articular surface, poor joints caused by extra-articular deformities, and unstable joints.
Iatrogenic factors (30%):
Iatrogenic factors such as long-term inappropriate use of corticosteroids.
Prevention
Hip osteoarthritis prevention
1. Maintain optimism: The prognosis of most patients is good. Simple X-ray bone hyperplasia does not necessarily appear symptoms.
2. Have a reasonable way of living and working: usually drink milk (several times), get more sun, and add calcium if necessary. Labor intensity should be adjusted or the type of work that causes the symptoms to worsen should be replaced to eliminate or avoid adverse factors such as strenuous exercise.
3. Avoid excessive load: avoid excessive load on the affected joints, and obese people should lose weight. Patients with knee and hip involvement should avoid standing, squatting and squatting for long periods of time.
4. Choosing the right shoes: It is best for the elderly to wear shoes with soft belt heel. The height of the heel of the shoe is about 2cm higher than the forefoot of the sole. The soles of the elderly are slightly larger, and there must be non-slip ripples to avoid falling. .
5. Use of ancillary facilities: Handles, canes, knee pads, walkers, wedge insoles (knee varus or everted) or other assistive devices can be used to reduce the load on the affected joints.
6. Auxiliary physiotherapy: The acute phase is mainly for relieving pain, swelling and improving function; the chronic phase is to enhance local blood circulation and improve joint function. Arthroplasty and joints containing metal components have been disabled for diathermy or ultrasound therapy to avoid deep burns.
Complication
Hip osteoarthritis complications Complications osteonecrosis
Osteoarthritis complicated by joint movement disorder of the limbs, in severe cases, limbs and flexion contracture deformities, and finally joint disability. People with knee varus, when standing and walking, are usually forced by the lateral muscles of the legs, and the inner side is not used. Therefore, the muscles of the legs are unevenly developed, and there are often more lateral muscles and less inner muscles. In this way, the formed leg muscle contour is curved, giving the impression that the bone is bent. It can also cause osteonecrosis.
Symptom
Hip osteoarthritis symptoms Common symptoms Joint pain Joint swelling Muscle atrophy Large trochanter pain
The main symptoms of clinical manifestations are joint pain and joint activity is not flexible. Physical examination revealed joint swelling, fluid, and muscle atrophy; the joints had buzzing when active and passive, and had varying degrees of mobility limitation and tendon. Some elderly people are accompanied by thickening of the distal interphalangeal joint. Hip arthritis is characterized by pain in the lateral part of the hip, groin, etc., which can be radiated to the knee. Specifically, hip pain, swelling, internal water accumulation, cartilage wear, spur hyperplasia, joint deformation, hip internal rotation and extension activities are limited, can not walk or even bedridden. The incidence of hip osteoarthritis in the Chinese population is less than that of Caucasians.
Examine
Examination of hip osteoarthritis
The routine examination of hematuria and erythrocyte sedimentation rate, mucin, and rheumatoid factor in the patient's disease are in the normal range. The synovial fluid was tested for color, transparency and mucin clot test. The white blood cell count was between 200 and 2000/mm3. There was no bacteria or crystallography on the microscopic examination, but cartilage fragments and fibers were visible. The number of fragments could be used to roughly estimate cartilage degradation. degree.
Diagnosis
Diagnosis and diagnosis of hip osteoarthritis
diagnosis
Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.
Differential diagnosis
1, rheumatoid arthritis This disease is particularly confused with the onset of rheumatoid arthritis, the following points can be identified: 1 onset usually rapid, there are sore throat, fever and white blood cells increased; 2 with multiple limbs and joints involved See, for migratory joint swelling and pain, no permanent damage after the disappearance of joint symptoms; 3 often accompanied by carditis; 4 serum anti-streptolysin "O", anti-streptokinase and anti-hyaluronidase are positive , and RF negative; 5 salicylic acid preparations often quickly and significantly.
2, tuberculous arthritis rheumatoid arthritis is limited to a single joint or a few joints should be identified with the disease. The disease may be associated with other areas of tuberculosis, such as spinal tuberculosis often with paraspinal abscess, more common in more than two joints. X-ray examination is not easy to distinguish in the early stage. If there is local bone destruction or paravertebral abscess shadow, it will help diagnosis. Joint cavity fluid is often positive for tuberculosis culture. Anti-tuberculosis treatment is effective.
3, other connective tissue diseases: systemic red wolf, scleroderma dermatomyositis and so on.
