Hip Joint Arthritis: Types, Causes, Signs, Symptoms, Treatment, Surgery, Diagnosis, Risk Factors

One of the most common causes of hip pain is hip joint arthritis.¹ Arthritis is a medical condition, which is progressive in nature, i.e. this disease usually begins gradually and over the time gets worse. The meaning of arthritis is joint inflammation. Arthritis of the hip joint or any other area does not have a cure. Treatment of arthritis of hip joint comprises of alleviating the pain and other symptoms. The hip joint can be affected by different types of arthritis. Treatment depends on the type of arthritis of the hip joint.

The types of arthritis ² which can affect a hip joint include:

• Rheumatoid arthritis.
• Osteoarthritis.
• Ankylosing spondylitis.
• Psoriatic arthritis.
• Systemic lupus erythematosus.

Osteoarthritis is the commonest type of arthritis.² The cause of osteoarthritis is wear and tear of the joints due to age, because of which it is often seen in older people than younger ones. The hip joint is made up of the femoral head, which is the ball-shaped end of the thigh bone. This fits into the acetabular socket, which is the hip socket. The hip joint is lined with a smooth cartilage, which enables the joint to move easily. When there is any wearing off this smooth cartilage then the rough surfaces of the hip joint rub against each other resulting in pain. Gradually, osteoarthritis can degenerate the hip joint and even cause permanent damage to it.

• Problems with the structure of the hip joint, such as femoroacetabular impingement and hip dysplasia.
• Increased aged individuals are at an increased risk for hip joint osteoarthritis.
• Obesity or being overweight increases the risk of having hip joint osteoarthritis.
• Previous injury or damage to the hip increases the risk of developing hip joint osteoarthritis. Osteoarthritis can also occur in individuals who do not have these risk factors.

Rheumatoid arthritis is a systemic medical condition. It affects the entire body along with the hip joint. The cause of inflammation in rheumatoid arthritis is an immune system response instead of wear and tear, as seen in osteoarthritis. A special capsule surrounds the hip joint, which protects it. This capsule contains a special lining known as synovial lining, which is filled with joint fluid that acts a lubricant to help the hip joint move smoothly. In rheumatoid arthritis of hip joint, there is swelling of the synovial lining resulting in pain and swelling of the hip joint. As time goes on, there is deterioration of the cartilage and bone from rheumatoid arthritis.

Rheumatoid arthritis can affect people of all ages. If it affects children, then it is known as juvenile rheumatoid arthritis. Women suffer more from rheumatoid arthritis than men. Rheumatoid arthritis often affects both the hip joints at the same time along with other joints. Patient also experiences fatigue and general weakness from rheumatoid arthritis.

Ankylosing spondylitis is a condition where there is chronic inflammation of the spine and the sacroiliac joint.³ In some cases, this can also cause inflammation in the hip joint. People of all ages can be affected from ankylosing spondylitis including children. This condition usually starts in individuals who are aged between 18 and 35 years. Men tend to suffer more from ankylosing spondylitis than women.

Patients suffering from ankylosing spondylitis will commonly experience flare ups of this condition where there is worsening of the symptoms followed by periods of remission where the patient has mild or no symptoms.

Systemic lupus erythematosus (SLE) is a systemic autoimmune disorder, which can affect any region of the body, including the hip joint. SLE affecting the joint will cause damage and inflammation to the joint.⁴ Lupus can affect individuals of any ages; however, most commonly affects women who are between 16 to 35 years of age.

Psoriatic arthritis occurs in relation with psoriasis, which is a skin condition. This condition can affect any type of joint including the hip joint. In psoriatic arthritis, patient experiences joint pain, stiffness and swelling. It is common to develop the skin condition (psoriasis) first before the development of psoriatic arthritis; however, some people can have psoriatic arthritis before the appearance of the skin condition.

• Patient suffering from hip joint arthritis experiences symptoms of pain in the hips. Pain can also be present in the groin region, buttocks or outer thigh.
• Symptoms of Pain due to hip joint arthritis is felt worse as soon as the patient wakes up in the morning and decreases with activity.
• Hip joint arthritis patient has difficulty in walking and can also walk with a limp.
• Vigorous or extended activity worsens the hip joint pain.
• There is stiffness in the hip joint with limited range of motion.
• Depending on the type of hip joint arthritis, (lupus or rheumatoid arthritis) patient can have weakness and fatigue.
• Lupus and rheumatoid arthritis often affects both the hip joints at the same time; whereas, psoriatic arthritis and osteoarthritis can only develop in one hip.
• Arthritis tends to occur in bouts or flares with periods of remission; however, some patients may have a constant level of pain without any flare ups.

• Patient’s medical history and physical examination are done where the range of motion of the hip joint is tested along with seeing if the patient walks with a limp.
• X-rays are done to find out if there are any abnormalities in the hip joint.
• Blood tests are done to look for antibodies, which are present in a specific type of hip joint arthritis, such as seen in lupus and rheumatoid arthritis.

• NSAIDs or anti-inflammatory medications, such as naproxen and ibuprofen are prescribed to relieve pain and swelling in the hip due to hip joint arthritis.
• Corticosteroids injections for hip joint arthritis help in relieving the pain and inflammation in the hip joint.
• Physical therapy for hip joint arthritis comprises of strengthening and stretching exercises which helps in improving flexibility, muscle tone and range of motion of the hip joint. Swimming is a very beneficial exercise for arthritis patients.
• Symptom-modifying antirheumatic drugs (SMARDs) and disease-modifying antirheumatic drugs (DMARDs) are the new categories of drugs, which can help with some types of arthritis. These are strong medicines and are not suitable for everyone suffering from hip joint arthritis.
• Walkers or canes help the patient in walking more easily and safely.

There are many patients suffering from hip joint arthritis who can benefit from surgery, as surgery will help in reducing pain along with enhancing the patient’s quality of life. The risks and benefits of surgery for hip joint arthritis should be thoroughly discussed between the surgeon and the patient.

• Total hip replacement surgery is done if there is severe damage to the hip joint due to hip joint arthritis.
• Hip osteotomy surgery can be done in less severe cases of hip joint arthritis where the joint surface is cut and repositioned, so that the healthy part of the hip joint bears the maximum weight of the body. Only selective patients can undergo this surgery for hip joint arthritis.

As mentioned before, arthritis has no cure including hip joint arthritis. It can only be managed with treatment. Arthritis usually starts slowly and worsens as the time goes on. In due course of time, all types of hip joint arthritis can cause permanent damage to the hip joint. Osteoarthritis commonly affects older people, whereas, other types of arthritis can affect younger individuals also. The following lifestyle modifications will help in managing hip joint arthritis better:

• Activities of the hip joint arthritis patient should be changed or modified so that the stress on the hip joint is less.
• It is important to maintain a healthy weight and lose weight if there is any excess weight.
• Hip joint arthritis patient should participate in daily exercise to build up strength and flexibility of the hip joints, as well as other joints.
• It is important that appropriate pain management is followed.

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Also Read:

• Home Remedies for Arthritis
• What is Arthritis (Joint Inflammation)?
• Hip Joint Osteoarthritis: Causes, Symptoms, Diagnosis, Treatment
• Hip Joint Rheumatoid Arthritis: Causes, Signs, Symptoms, Treatment
• Hip Joint Septic Arthritis: Causes, Symptoms, Treatment, PT, Surgery
• Hip Joint Psoriatic Arthritis: Causes, Symptoms, Treatment, PT, Surgery