Inflammatory Arthritis of the Hip

The most common types of inflammatory arthritic conditions of the hip include:

• Rheumatoid Arthritis: Systemic disease of the immune system commonly affects multiple joints on both sides of the body at the same time. With this condition, the synovium thickens, swells, and produces chemical substances that attack and destroy the articular cartilage covering the bone.
• Ankylosing Spondylitis: Chronic inflammatory disease of the spine and the sacroiliac joints (junction where the spine meets the pelvic bone). It may affect other joints, as well, including the hip.
• Other autoimmune diseases such as Systemic Lupus Erythematosus (SLE): A disease in which the body’s immune system attacks its own healthy cells and tissues. It can cause inflammation in any part of the body, and most often affects the joints, skin, and nervous system. The disease occurs in young adult women in the majority of cases.

The typical symptom of arthritis is joint pain. Inflammatory hip arthritis is mainly characterized by an aching pain in the groin region, outer thighs or buttocks. The pain is commonly most severe in the morning which sometimes lessens with activity during the day. Vigorous activities may result in increased pain and stiffness and limit your movement making walking difficult

Inflammatory hip arthritis can be diagnosed by physical examination. Your doctor will ask you to move your hip in different directions to find out which motions are restricted or painful. X-rays and laboratory tests may be ordered to diagnose or rule out other conditions. X-rays may show thinning or erosion in the bones or loss in joint space. Laboratory studies will show the presence of a rheumatoid factor or other antibodies.

The treatment options vary depending on the diagnosis.

Non-surgical treatment: Inflammation of in the hip joint is can be managed by non-surgical treatments which may provide relief with relatively few side effects. This is often under the guidance of a rheumatologist. * Anti-inflammatory medications or corticosteroids may help reduce the inflammation.

• Disease-modifying antirheumatic drugs (DMARDs). These drugs act on the immune system to help slow the progression of disease. Methotrexate and sulfasalazine are commonly prescribed DMARDs.
• Physical therapy may be recommended to help you increase the range of motion and strengthening exercises to maintain muscle tone.
• Assistive devices such as canes or walkers can make your daily living activities easier. Although there is no cure for inflammatory arthritis, there have been many advances in treatment, particularly in the development of new medications. Early diagnosis and treatment can help patients maintain mobility and function by preventing severe damage to the joint.

Surgical treatment: Surgery is considered the last treatment resort when the above non-surgical treatment options fail to reduce the symptoms. The type of surgery to be performed depends on your age, condition of the hip joint, and the type and progression of the inflammatory disease. The goal of the surgery is to relieve pain and improve the joint motion. The most common surgical procedure for advanced inflammatory arthritis of the hip is a total hip replacement.

• Total Hip Replacement: Indicated for patients with rheumatoid arthritis and ankylosing spondylitis.
• Bone Grafts: Recommended for patients with SLE. These grafts aim to build new blood cells to replace the old dead cells.
• Core Decompression: Helps to reduce bone marrow pressure and encourages blood flow. Core decompression is another treatment option for patients with SLE.
• Synovectomy is the procedure of removal of a part or whole of the joint lining. This is indicated if the inflammation has not affected the cartilage but is limited to the joint lining or synovium.