Inflammatory Arthritis of the Hip

Arthritis means "an inflammation of the joint." There are two primary types of arthritis:

• Some arthritis, such as osteoarthritis, occurs when the cartilage at the end of the bones erodes.
• In arthritis such as rheumatoid arthritis, inflammation of the joints occurs as part of a disease.

• Rheumatoid arthritis. A systemic disease of the immune system that usually affects multiple joints on both sides of the body at the same time.
• Ankylosing spondylitis. A chronic inflammation of the spine and the sacroiliac joint (the point where the spine meets the pelvic bone) that can also cause inflammation in other joints.
• Systemic lupus erythematosus. An autoimmune disease in which the body harms its own healthy cells and tissues

Symptoms

The most common sign of arthritis is joint pain. When inflammatory arthritis of the hips strikes, you may feel a dull ache in your groin, outer thigh or buttocks. Although pain is worse in the morning and is relieved as you move, a lot of activity can lead to more pain and stiffness.

Diagnosis

To assess and diagnose your condition, your physician will conduct a thorough exam:

• Your doctor may ask you to move your hip to see what causes you pain.
• Your doctor will ask questions about how you walk, where you feel pain and if you are experiencing joint pain elsewhere in the body.
• X-rays may be ordered so your doctor can see any bone erosion, excess joint fluid or decreased space between the joints.
• Lab tests may be ordered, which can show certain antibodies, such as rheumatoid factor.

Treatment

Your treatment depends on your diagnosis, as well as your age, stage of your condition and your personal goals. Your doctor will work with you to create a treatment plan that is unique to you.

Nonsurgical treatment

Generally, conservative, nonsurgical treatments are tried first. They can provide pain relief with relatively few side effects or complications. Some of these conservative treatments may include some or all of the following:

• Aspirin and ibuprofen, which can help reduce inflammation.
• Corticosteroids, which can be taken by mouth, injection or as a cream applied to the skin.
• Disease-modifying antirheumatic drugs (DMARDs), such as methotrexate and sulfasalazine, can slow the progression of inflammatory arthritis.
• Assistive devices, such as reachers, canes and walkers can make daily living easier and less painful.
• Physical therapy can improve muscle tone and increase your range of motion.

Surgical Treatment

If your pain and inflammation don't respond to conservative treatments, surgery is often the next course of action. Before determining a specific type of surgery, your doctor will assess your age, condition of your joint, stage of disease and type of arthritis.

The most common surgical procedures performed for inflammatory arthritis of the hip include:

• Total hip replacement. This surgery is recommended for patients with rheumatoid arthritis or ankylosing spondylitis because it relieves pain and improves motion.
• Bone grafts. Patients with systemic lupus erythematosus have a higher incidence of osteonecrosis, which causes bone cells to die off. Bone grafts can be given to build new bone cells.
• Core decompression. Another option for patients with systemic lupus erythematosus and osteonecrosis is core decompression, which reduces bone marrow pressure and encourages blood flow.
• Synovectomy. This procedure, which involves removing part or all of the joint lining, may be effective if the disease is limited to the joint lining and has not affected the cartilage.

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