Enthesopathy of Hip: Causes, Symptoms, Treatment
What is Enthesopathy of Hip?
To understand about Enthesopathy of Hip, it is important to understand what does enthesopathy mean? The areas where the tendons and ligaments attach to the bone are called enthesis. When these areas get inflamed and painful then that condition is called Enthesopathy.1
Thus, when the area where tendons and ligaments attach to the hip bone becomes inflamed then it leads to development of what is called as Enthesopathy of Hip. This is basically an arthritic disorder and affects the normal functioning of the hip.
An individual with Enthesopathy of Hip will find it difficult to move the hip in any direction and will also find it difficult to ambulate normally. The affected individual will also find it very tough to carry out activities of daily living due to pain and decreased range of motion of the hip as a result of Enthesopathy of Hip.
The majority of the changes due to Enthesopathy of Hip are seen at the femoral head of the hip and the joint acetabulum while the anterior capsule is the portion of the hip that is least affected by Enthesopathy of Hip. Of late, PRP injections have shown great promise in treating acute cases of Enthesopathy of Hip.
What are the Causes Of Enthesopathy of Hip?
Some of the common causes of Enthesopathy of Hip are:
- Inflammatory disorders affecting the hip like rheumatoid arthritis can cause enthesopathy of hip 2
- Psoriatic arthritis is yet another condition that can affect the hip and cause Enthesopathy of Hip
- Reactive arthritis is also a medical condition that may cause Enthesopathy of Hip
- Osteoarthritis is a common cause of Enthesopathy of Hip
- Other medical conditions like Crohn's disease or Reiter's syndrome can also cause Enthesopathy of Hip
Apart from this any physical injury or trauma to the hip like a slip and fall or a motor vehicle accident can also cause Enthesopathy of Hip. Additionally, recreational drug abuse, some sort of infection, or a surgical procedure to the hip like a hip debridement for arthritis or a replacement may also cause Enthesopathy of Hip.
What are the Symptoms of Enthesopathy of Hip?
Some of the symptoms of Enthesopathy of Hip are:
- Severe pain with movement of the hip
- Decreased range of motion of the hip 2
- Problems with ambulation due to pain and discomfort at the hip
- Hip soreness.
How is Enthesopathy of Hip Treated?
The treatment for Enthesopathy of Hip is generally conservative and includes utilization of NSAIDs for calming down the pain and inflammation. The NSAIDs may either be given topically or orally depending on the severity of the pain.3 The most preferred medications for treatment of Enthesopathy of Hip are acetaminophen and naproxen.
If NSAIDs are not effective in treating the patient's symptoms then the next step towards treatment is steroid injections to bring down the inflammation due to Enthesopathy of Hip.
If both of these agents fail to provide any relief then medications like Humira or Enbrel which are anti-TNF agents are used to treat Enthesopathy of Hip. In addition to the medications, the patient will have to undergo aggressive physical therapy to regain lost range of motion and strength of the hips as a result of Enthesopathy of Hip.
The physical therapy may use modalities like ultrasound, electric stimulation, and massage as a mode of strengthening the hip and bring back the range of motion lost due to Enthesopathy of Hip.
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