Hip Arthritis

What is arthritis of the hip joint?

The hip joint is a commonly affected joint by many conditions which lead to wear of the cartilage surface that cover the femoral head and the acetabulum of the pelvis. While osteoarthritis is the commonest cause for the development of hip arthritis, many other conditions such as a group of conditions called inflammatory arthritis, of which a common condition is rheumatoid arthritis. There are many other conditions that are less common causes of hip arthritis such as trauma, childhood hip conditions, hip joint infections (septic arthritis) and avascular necrosis– where a part of the femoral head dies due to a lack in blood supply, leaving the overlying cartilage with no support and leading to collapse. 

Hip Arthritis

Osteoarthritis:

It is characterized by progressive wearing away of the cartilage of the joint. As the protective cartilage wears down, the bone ends rub against each other and cause pain in the hip. 

Rheumatoid arthritis:

This is an autoimmune disease in which the tissue lining the joint (synovium) becomes inflamed, resulting in the production of excessive joint fluid (synovial fluid). This leads to loss of cartilage causing pain and stiffness.

Traumatic arthritis:

This is a type of arthritis resulting from a hip injury or fracture. Such injuries can damage the cartilage and cause hip pain and stiffness over a period

Who is affected by hip arthritis?​

Hip arthritis can affect people of all ages. It affects approximately 5-6% of the population, but most commonly it affects patients who are in their 60s and 70s. Younger patients who have hip arthritis in their 30s and 40s usually have a history of childhood hip conditions such as hip dysplasia (childhood hip dislocation), Perthes disease or slipped upper femoral epiphysis; or conditions of abnormal joint anatomy, Femoro-Acetabular Impingement (FAI). A family history of arthritis, obesity, some occupations such as farmers and laborers.

Hip Arthritis

What are the symptoms of hip arthritis?

Hip arthritis is usually a chronic condition that gradually worsens over time. The symptoms can be mild for a long time until; in some cases, sudden deterioration can occur with an acute event such as trauma, increased pressure on the hip due to trauma, work or exercise and can make this condition very painful, leading to rapid deterioration. 

The common symptoms in hip arthritis are:

How is hip arthritis diagnosed?

Hip Arthritis

The first step is to have a clinical assessment by your doctor. This includes a clinical history and examination of the hip joint. The diagnosis is usually confirmed with a series of x-rays of the pelvis and the hip joint.

 

Other more complicated tests like MRI scans and not usually required in the majority of cases, but they may be needed in other less common conditions. Blood tests may be required in the assessment of causes of arthritis other than osteoarthritis. Inflammatory markers, serological markers and certain biochemical tests may be required in inflammatory arthritis, septic arthritis and crystal arthropathy.

The first line of management is by simple non-surgical measures such as:

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