Inflammatory Arthritis of the Hip

There are three main types of inflammatory arthritis that affect the hip joint:

• 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 result in inflammation in other joints.
• Systemic lupus erythematosus – An autoimmune disease in which the body harms its own healthy cells and tissues.

What are the symptoms?

Symptoms of inflammatory arthritis of the hip include:

• Fever
• Loss of appetite
• Fatigue
• Pain and stiffness in the hip
• A dull, aching pain in the groin, outer thigh, knee, or buttocks
• Pain that is worse in the morning or after a period of inactivity, but gets better as you move around
• Pain and stiffness increases with vigorous activity
• Pain in the joint so severe that there is difficulty walking and causes a limp

What are the causes and risk factors?

It is suspected that genetics plays a part in causing inflammatory arthritis. Other than that, the cause of inflammatory arthritis is unknown.

What is the diagnosis?

A history of the injury and a physical examination of the hip will be conducted by the Doctor. The doctor will check on the surrounding tendons, muscles and ligaments, your range of motion and if there is pain or tenderness around the hip. Increased pain during movement may indicate a case of inflammatory arthritis.

Imaging tests such as an x-ray will be taken, which will show whether there is any changes in bone structure, any loss of joint space or excess fluid in the joint. Blood tests may also be taken, which can reveal if the inflammation is due to rheumatoid arthritis, or if there is any other cause to the inflammation present.

What are the treatment options?

Depending on the type of inflammation, the treatment recommended will vary.

Nonsurgical treatment options include:

• Medications and anti-inflammatory drugs such as ateceminophen and ibuprofen for pain relief
• Steroid injections such as injecting corticosteroid to relief pain
• Physiotherapy to regain muscle strength and restore your range of motion and mobility
• Walking aids, such as a walker or cane to help you in daily activities.

Should nonsurgical treatments fail to alleviate your symptoms, surgery may be recommended. The 2 most common procedures for inflammatory arthritis of the hip are total hip replacement and synovectomy.

• Total hip replacement

The damaged cartilage and bone gets removed, and then new metal or plastic joint surfaces will be positioned to restore your hip function. Total hip replacement is usually recommended for patients with rheumatoid arthritis or ankylosing spondylitis to relieve pain and improve range of motion.

• Synovectomy

Generally used to treat the early stages of inflammatory arthritis, this procedure involves removing the whole or part of the joint lining (synovium). This is only effective if the disease is limited to the synovium, and has not affected the articular cartilage covering the bones.

What is the recovery process after surgery?

The recovery period depends on the type of surgery that was performed. Physiotherapy may be recommended by your doctor, which will help you regain your muscle strength and restore mobility in your hip. Do expect to use a cane or walker for a period of time after your surgery.

What are the risks and complications of surgery?

As with all surgery, complications may occur. Complications of surgery include:

• Infection
• Excessive bleeding
• Blood clotting
• Hip dislocation
• Uneven limb length
• Blood vessels or arteries damage