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hip-osteoarthritis-pathogenesis-and-clinical-findings

Hip Osteoarthritis: Pathogenesis and clinical findings Authors: Ebrahim Alawadhi, Alyssa Federico Reviewers: Mehul Gupta, Tara Shannon, Yan Yu*, Richard Ng* * MD at time of publication Primary causes Aging ↓ Synovial fluid in the hip joint Secondary causes Gender Females > males Genetics Family history of osteoarthritis High-impact sports, activities, and occupations Repetitive stress on the hip joints Obesity ↑ Loading on hip joints Inflammatory disease (e.g. Rheumatoid arthritis ) Trauma Infection (e.g. septic arthritis) Anatomical abnormality (e.g. developmental hip dysplasia) ↑ Cartilage stiffness and degeneration ↑ Friction in the hip joint with movement Changes in normal hip architecture Abnormal load on the hip joint Radiographic changes See Osteoarthritis (OA): X-Ray Features slide Repeated attempts to repair cartilage damage and bone Bone spur (bony growth) formation in joint Joint fluid accumulation from mild inflammation of the joint Stiffness Limited joint movement Hip Osteoarthritis Multifactorial condition that manifests as degeneration of cartilage, bone, and synovium in the hip joint ↓ Cartilage between femoral head and acetabulum ↑ Bone on bone contact Mechanical symptoms (crepitus, locking, clicking, catching) Bones rubbing together activates nociceptors within the hip joint Nociceptors further aggravated by actions that ↑ bone on bone contact (e.g. prolonged loading, movements that ↓ joint space) Worsening pain in the groin region Favour the affected leg to avoid pain while walking ↓ Space for the femoral head to move ↓ Range of motion of affected hip joint Limited range of motion when walking Antalgic gait ↓ Use of muscles around the affected hip Muscular atrophy around the hip C Sign: patient identifies location of pain by cupping lateral hip with one hand, which creates a “C” shape with that hand Pain in groin region ↑ Sensitivity of surrounding nerves Radiating pain to buttocks and knee Inactivity Hip instability when walking Muscle contractures ↑ Falls Legend: Pathophysiology Mechanism Sign/Symptom/Lab Finding Complications Published March 6, 2022 on www.thecalgaryguide.com