Inflammatory Arthritis of the Hip

Inflammatory Arthritis of the Hip

Article
Bone, Muscle, & Joint
Diseases & Conditions
Contributed byKrish Tangella MD, MBAOct 11, 2018

What are the other Names for this Condition? (Also known as/Synonyms)

  • Hip Arthritis - Inflammatory Arthritis
  • Inflammatory Arthritis of the Hip Joint
  • Rheumatoid Arthritis causing Hip Arthritis

What is Inflammatory Arthritis of the Hip? (Definition/Background Information)

  • Arthritis is a joint disorder characterized by an abnormal inflammation that affects one or more joints, within the body. Generally, arthritis increases with age. The majority of individuals who develop the condition begin experiencing pain and stiffness, in the affected joint or limb
  • Inflammatory Arthritis of the Hip affects the joints of the hip; especially the cartilage, bone, soft tissue surrounding the joint, muscles, and tendon
  • There are many causes of Arthritis of the Hip. Major causes are: Degenerative osteoarthritis, post-traumatic arthritis, rheumatoid arthritis (RA), ankylosing spondylitis, systemic lupus erythematosus (SLE), and gout (gouty arthritis)

There are several different types of arthritis. Common types of Inflammatory Arthritis of the Hip Joint that individuals may develop include:

  • Degenerative Osteoarthritis of Hip: It is the most common type of arthritis. Osteoarthritis is characterized by a progressive degeneration of cartilage, bones, or synovial membrane, within the joint, usually over a prolonged time period
  • Post-Traumatic Hip Arthritis: It is a type of osteoarthritis. Post-Traumatic Hip Arthritis is a progressive degenerative disorder that may develop after a significantly traumatic injury to the hip region
  • Avascular Necrosis of Hip: Avascular Necrosis of Hip occurs when blood flow to the hip joint is disrupted. This results in tissue damage (of both the bone and soft tissue surrounding the joints). Common causes of avascular necrosis include, chronic steroidal therapy, sickle cell disease, and trauma to the joint
  • Rheumatoid Arthritis involving the Hip: Rheumatoid arthritis is an autoimmune systemic inflammatory condition that may affect the lining of joints, surrounding tissues, or organs, within the body
  • Ankylosing Spondylitis causing Hip Arthritis: Ankylosing spondylitis is an inflammatory disorder that causes chronic inflammation in the spine and sacroiliac joint (a pelvic joint)
  • Systemic Lupus Erythematosus causing Hip Arthritis: Systemic lupus erythematosus is an autoimmune systemic inflammatory disorder that may affect any part within the body, including the hip-joint.  This disorder occurs when a patient’s immune system creates antibodies that accidentally attack healthy tissues and organs, within the body
  • Gout involving Hip Joint: A complex type of inflammatory arthritis, gouty arthritis is a medical condition caused by a high level of uric acid within the blood. A gout attack occurs with the abnormal formation of crystallized uric acid, resulting in inflammation of the joints. Gout generally affects small joints of the foot. Involvement of hip joint by gout, is not common

Who gets Inflammatory Arthritis of the Hip? (Age and Sex Distribution)

  • Individuals of all age, race, or ethnic groups, and belonging to any gender, may develop Inflammatory Arthritis of the Hip
  • However, this disorder predominately occurs in middle-aged to elderly individuals. Those with an autoimmune disorder or systemic disease, are also prone to the condition
  • Young athletes who sustain a traumatic joint injury while participating in a rough or high-impact sport, may develop Post-Traumatic Hip Arthritis
  • Hip Degenerative Osteoarthritis and Systemic Lupus Erythematosus causing Hip Arthritis is more common in females

What are the Risk Factors for Inflammatory Arthritis of the Hip? (Predisposing Factors)

Common risk factors associated with Inflammatory Arthritis of the Hip include:

  • Age: Inflammatory Arthritis of the Hip may develop in individuals of all ages, but is rarely diagnosed in individuals under the age of 40 years. However, since it is a gradually progressing disorder, the risk of developing this condition usually increases with age
  • Previous joint injury: Any previous injury to the hip may increase an individual’s risk of developing the condition
  • Family history: Those having an immediate family member or a relative with a history of rheumatoid arthritis condition
  • Obesity: Excess body weight associated with obesity may cause abnormally increased pressure on the joints
  • Athletics: Individuals who participate in rough or high-impact sports, such as football/basketball, are prone to developing Post-Traumatic Hip Arthritis
  • Joint infection: Infection within the hip joints may contribute to the development of the condition

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Inflammatory Arthritis of the Hip? (Etiology)

  • Currently, the underlying cause of Inflammatory Arthritis of the Hip, is unknown
  • A contributory factor associated with the cause of this disorder includes the individual’s family history. Those having an immediate family member or a relative with a history of this condition, may develop Inflammatory Hip Arthritis

In Hip Arthritis, the cartilage tissue covering the joint is damaged, either due to inflammation (such as rheumatoid arthritis), or due to repeated stress/trauma (such as degenerative osteoarthritis). The thinning of cartilage causes bone-on-bone contact in the joints. Once the bones are rubbing on each other, it causes pain, stiffness, and abnormally restricted joint movement.

What are the Signs and Symptoms of Inflammatory Arthritis of the Hip?

Arthritis is a gradual and progressive disorder that usually worsens over time. Common signs and symptoms associated with Inflammatory Arthritis of the Hip include:

  • Noticeable pain and tenderness (pain on touch)
  • Swelling of tissue (due to inflammation) around the hip joint
  • Stiffness, reduced mobility of the hip joint
  • Difficulty walking

How is Inflammatory Arthritis of the Hip Diagnosed?

Diagnostic methods that a physician may use to help diagnose Inflammatory Arthritis of the Hip include:

  • Physical examination: This condition can be usually diagnosed by a thorough physical examination of the hip, by the physician. In addition to this, a complete medical history will aid in arriving at the correct cause of Hip Arthritis
  • X-rays: X-rays are utilized to visualize images of the hip. It can also help the physician rule out other possible causes of hip discomfort
  • Blood test: A blood sample is drawn from an artery or vein using a needle and taken to a laboratory for analysis. Blood tests such as complete blood count (CBC), rheumatoid factor (RF) levels, cultures of the joint fluid, lupus blood tests (SLE panel), help the healthcare provider arrive at a cause for Hip Arthritis
  • MRI and CT scan of the hip joint: This helps assess the damage to the joint and surrounding tissue
  • Arthroscopy: During this procedure a surgeon inserts a thin tube attached to a camera (a fibro-optic camera) into the joint, via a small incision on the skin of the joint. Visualizing the joint via a camera helps the healthcare provider arrive at a cause of Hip Arthritis. Arthroscopy is considered to be a minimally invasive diagnostic tool

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Inflammatory Arthritis of the Hip?

Inflammatory Arthritis of the Hip is a progressive, inflammatory, autoimmune disorder that can affect several joints and gradually worsen over time. The complications could include:

  • Chronic pain and stiffness within the hip joint, which may prevent individuals from performing their routine daily activities
  • Some cases may cause permanent disability (frozen joints)

How is Inflammatory Arthritis of the Hip Treated?

The treatment measures depend on the cause of Hip Arthritis and these are grouped as non-surgical and surgical treatment methods. A healthcare provider may start with non-surgical treatment methods before adopting surgical procedures and techniques. However, in some cases, the healthcare provider may elect to use surgical treatment methods, if the symptoms or the condition, cannot be managed with conservative non-surgical methods.

Nonsurgical treatment measures that may help relieve pain and improve range of motion of the hip joint include:

  • Rest: Any activity that aggravates the hip condition further should be avoided. The physician usually advises to refrain from all such activities, until the symptoms stop
  • Heat and ice: Applying a damp heated towel or ice to the hip joint, can help reduce pain and swelling
  • Assistive device: Occasionally, specific assistive devices, such as a cane or walker, are recommended. This may help the individual in performing some of their everyday activities
  • Non-steroidal anti-inflammatory medication: Oral medications, such as ibuprofen and naproxen, can help decrease the hip pain
  • Corticosteroids: Oral steroidal medications, such as prednisone, may help decrease inflammation and increase range of motion
  • Physical therapy: After the signs and symptoms have decreased, it is important to begin some light motion exercises. Physical therapy may help restore strength, as well as flexibility, in the muscles
  • Injection of steroids into the joints: Steroid injection into the joint helps in temporary relief of symptoms, such as pain, and in improving the range of motion. It is important to note that steroidal injections only give temporary relief and prolonged episodes of such injection may injure the joints in the long run

Surgical treatment measures include:

  • Arthroscopic hip chondroplasty: Arthroscopic chondroplasty is a surgical intervention technique that involves repairing the damaged cartilage within the hip; thus allowing the growth of healthy tissue in its place. This surgical procedure is performed using an orthopedic device, called an arthroscope, and is useful in treating mild to moderate rheumatoid arthritis
  • Arthroscopic hip synovectomy: Arthroscopic synovectomy is a minimally invasive surgical procedure that involves a partial or complete removal of the synovial membrane within the hip joint
  • Bone graft: A bone graft is used to replace damaged or missing bones associated with complex bone fractures
  • Total hip arthroplasty: Total hip arthroplasty involves the complete removal of cartilage within the hip joint. The hip joint is then removed and replaced by a metal and plastic prosthetic implant. A physician will recommend this surgical procedure if the inflammatory disorder affects the entire hip joint

How can Inflammatory Arthritis of the Hip be Prevented?

  • Currently, there are no preventable measures associated with Inflammatory Arthritis of the Hip
  • However, if these inflammatory disorders are diagnosed early, treated aggressively, and appropriately; then, the progression of this disabling condition may be slowed or decreased
  • Regular stretching exercise helps decrease the incidence of development of Arthritis of the Hip

What is the Prognosis of Inflammatory Arthritis of the Hip? (Outcomes/Resolutions)

  • The long-term prognosis of Inflammatory Arthritis of the Hip, depends on the severity of the disorder
  • Other factors that determine the prognosis include: A serious increase of symptoms associated with inflammatory arthritis (flare-up), an arthritic remission, and provision of appropriate control and treatment of the disorder
  • If the cause of Hip Arthritis is detected early, and proper, aggressive treatment provided; then, the quality of life can be substantially improved. This also helps avoid any serious complications from arising in the hip joint
  • Inflammatory Arthritis of the Hip is a debilitating disorder. A high percentage of individuals who develop this disorder, may experience continuous inflammation and a gradual degeneration of the hip joint, over their lifetime

Additional and Relevant Useful Information for Inflammatory Arthritis of the Hip:

One must be careful while adopting unproven and non-evidence based claims, such as copper bracelets and magnets, for treating joint disorders. Your healthcare provider is the best source for advice, on new methods of treatment.

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Krish Tangella MD, MBA

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