sore buttocks
Introduction
Introduction Sore on the buttocks is also one of the common complaints in outpatient clinics. Because of the special location, there are many times when it is often confused with lower back pain and sciatica. In addition to the lesions of the joint itself, the pain in the buttocks should also exclude the lesions around the joints and the pain in the distant lesions.
Cause
Cause
Reasons for sore hips:
First, patients who take steroids for a long time are prone to cause hypoxic necrosis of the femoral head, so it is a high risk group.
Second, patients with systemic lupus erythematosus are at high risk.
Third, alcohol abuse is also a high risk factor.
Fourth, diving activities are risk factors. This is because on the one hand, the gravity of the oxygen cylinder is carried for a long time, and on the other hand, floating in the water in a short time is also easy to cause the helium in the blood to turn into small bubbles, causing systemic blood vessel embolism and diving. disease. If you have these risk factors, you should be especially careful, the chance of suffering from sore hips will be higher than normal.
Examine
an examination
Related inspection
Neurological examination of anti-skeletal muscle antibodies
Diagnosis of soreness in the buttocks: soreness in the buttocks, lower back, lower back, hips, and thighs.
Differential diagnosis of tired buttocks includes: arthritis, joint capsules, muscle fascia pain syndrome, neuropathy, and other pathologies.
There are many diseases of soreness, including groin of the groin, simple osteoarthritis, and disc prolapse (a common between L3 and L4), or diseases such as kidney stones are directly or involved in the buttocks. All of the above are diagnoses that need to be identified one by one.
The soreness of the buttocks, lower back, lower back, hips, and thighs.
Diagnosis
Differential diagnosis
Differential diagnosis of soreness in the buttocks includes: arthritis, consumps, muscle fascia pain syndrome, neuropathy, and other pathologies.
Degenerative arthritis (osteoarthritis, OA for short). Degenerative arthritis, as its name suggests, is a degenerative condition that occurs after long-term use of the joint. Degeneration of the hip joint is one of the common diseases in the elderly. Patients often feel sore hips after exercise, especially when lifting heavy objects, the symptoms can be improved after rest. Patients with more severe symptoms, even at rest, feel sore, and this symptom is particularly severe at night.
Infectious arthritis. It is because of the inflammatory reaction caused by bacterial infection. The most common pathogen is Staphylococcus aureus, which enters the joint cavity by blood circulation. Patients usually have a fever, severe hip pain, and joint swelling that sometimes does not occur. During the physical examination, the patient can only perform a slight bending motion and usually cannot tolerate any movement. Immediately after diagnosis, hospitalization should be given, intravenous antibiotics should be given, and X-ray films should be taken in the shortest time, and orthopedic specialists should be consulted. If necessary, surgically remove the area of suppuration as soon as possible to avoid joints. Permanent damage.
Inflammatory arthritis. It is caused by an immune rheumatic disease. Usually, patients complain that the joints are particularly stiff in the morning, but after a few hours of activity, the symptoms are mostly alleviated. The two most common diseases in this area include rheumatoid arthritis (RA) and ankylosing spondylitis (AS). The easiest way to distinguish is to take an X-ray film. In this area, ankylosing spondylitis is typical of sacroilitis, and rheumatoid arthritis does not. If the diagnosis is established, it should be consulted or referred to a suitable immunology rheumatologist.
Joint capsule inflammation. The joint capsule is a protective cushion used to cushion and lubricate, reducing the joint's direct wear by external forces. There are 18 joint capsules in this area, and there are three most inflamed parts. Including the greater trochanteric joint capsule, the intestinal lumbar joint capsule, and the ischial joint capsule. In the physical examination, different joint capsules can be tested. If there is severe pain, the diagnosis can be established. X-ray examination usually cannot produce images of soft tissue inflammation, so it is not necessary to check.
Treatment of joint capsules must be multi-pronged, local hyperthermia, ultrasound, massage, with non-steroidal anti-inflammatory drugs can generally achieve satisfactory results, such as symptoms can not be alleviated in the above way, can be implemented for localized inflammation Steroid injection. If the treatment for a few weeks has not been effective, consider computer tomography to rule out the possibility of other malignant diseases. Treatments including topical hyperthermia, ultrasound, massage, stretching exercises, the use of anti-inflammatory drugs, or topical steroid injections can alleviate clinical symptoms.
Muscle fascia pain syndrome. This part of the intestinal fascia can stretch from the outside of the intestine to the outside of the knee. Once there is inflammation, this area will have a clinical pain, especially when lying on the side of the inflammation, painful It feels even stronger. Pulling the fascia while the thigh is adducted can also cause severe pain. These are the reference for diagnosis. Fibromuscular pain occurs in women, and there are clinical symptoms such as body aches, sleep disorders, prostration, and even a large bowel dysfunction.
Neuropathy can also cause soreness in the buttocks. The most common cause is the pain caused by compression of the lateral femoral cutaneous nerve surrounded by surrounding soft tissue. The patient develops soreness on the outside of the buttocks and thighs and paralysis of the epidermal nerves. The effect of drug treatment is poor. Performing surgical incision of soft tissue can effectively alleviate neuropathy.
