Hip joint inflammation , which leads to pain and limitation of the motor function of the thigh, is called bursitis. Pathology is quite common among women and can occur against the background of physical overload, concomitant diseases or under the influence of infectious pathogens. In our article, we will examine in more detail what is bursitis of the hip joint. Causes, symptoms, diagnosis and treatment of pathology will also be considered under the topic.
Bursitis concept
Bursitis is an inflammatory disease that affects the synovial periarticular bag, or bursa. Synovial bags adjacent to the bone joints - the shoulder, elbow, knee, hip - and perform the function of shock absorbers, smoothing the friction when sliding the muscles in relation to the bone. Synovial bags contain fluid that can become inflamed under the influence of certain factors.
The femur is characterized by a bone protrusion, which is called the greater trochanter. Muscles that support the functioning of the hip joint are attached to this formation. A synovial bag adjoins the spit of the thigh, in which irritations and inflammatory processes can occur, leading to the development of bursitis of the hip joint.
Other synovial bags are adjacent to the hip joint, however, most often inflammation occurs in three of them:
- skewer bag;
- iliac scallop bag;
- sciatic bag.
Types of bursitis
The inflammatory process that occurs in the trochanteric bag causes a pathology of the same name - trochanteric bursitis (trocharteritis). This type of synovial bag is located near the large trochanter of the thigh. With inflammation, pain occurs in the region of the greater trochanter - a bone protrusion on the femur (external). Next to this bag is an undertrovert synovial bag, the inflammation of which proceeds identically to the inflammation of the trochanteric bursa and is eliminated by the same methods.
The iliac-scallop bursa is located in front of the lumbar-iliac muscle. Pathology in this synovial bag leads to iliac scallop bursitis. Since this bag is connected to the joint cavity, the inflammation in it resembles coxitis (an inflammatory process of the hip joint). Pain occurs in the anteroposterior thigh (just below the groin). When the hip joint is extended, pain intensifies, swelling or swelling may occur.
The sciatic bag is localized at the point of attachment of the muscles to the sciatic tubercle. Inflammation in it leads to sciatic bursitis, which is characterized by pain when the hip is bent.
Symptoms of bursitis of the hip joint
The main manifestation of bursitis is pain in the hip joint, which spreads mainly along the outer surface of the thigh. The early stages of the pathology are characterized by acute and intense pain. With the further development of the disease, the pain becomes less pronounced.
Pathology takes a chronic form. In this case, in the area of localization of the inflammatory process, a swelling occurs, which acquires a rounded shape and is characterized by a soft consistency. The chronic form of bursitis does not cause dysfunction of the affected joint. Patients note the absence of burning pain.
In the acute stage of the pathology, the amount of fluid in the cavity of the affected bag increases — cysts filled with exudate form — special symptoms of bursitis of the hip joint.
If the inflammatory process in the synovial bag occurs under the influence of infection, purulent bursitis develops, in which there is a sharp soreness, especially when the limb is abducted and the hip is extended and bent. Edema forms on the outside of the thigh; the patient cannot bend or straighten the thigh to the end.
In addition to pain, there are additional symptoms of bursitis of the hip joint:
- a swelling occurs at the site of the lesion, the size of which in diameter can reach up to 10 cm;
- swelling around the inflamed bag;
- heat;
- deterioration in general condition.
Signs of bursitis in animals
Trocharteritis is a disease that occurs not only in humans, but also in domestic animals. Often, dog owners are faced with such a pathology of their pets as a hygroma - this is a swelling that forms on the surface of the ulnar process, in the calcaneus, as well as in the location of the greater trochanter of the thigh. If a thick fibrous capsule has formed on the paw, the cavity of which is filled with liquid, we can say that there is a hygroma (bursitis) of the hip joint. Symptoms in dogs are as follows:
- the area of the limb (paw) is hot;
- the animal holds the limb in weight;
- the body temperature of the dog exceeds the norm, sometimes reaching 39.5 degrees;
- mobile swelling forms under the skin, which can spontaneously open, and pus follows from them.
Pathology often occurs either in very young or in old animals. Large dog breeds are also more susceptible to disease.
Bursitis may occur due to:
- infectious pathogens;
- wrong litter for the animal;
- uneven physical activity;
- hypothermia.
Human Risk Factors
Hip bursitis is found mainly in women than in men. Basically, the pathology is diagnosed in the fair sex of middle or old age. Young men are rarely diagnosed with hip bursitis. The causes and treatment that is required to eliminate the manifestations of the disease can be very individual. Everything will depend on the body of a particular person. However, there are common factors whose effect leads to the development of pathology.
Hip bursitis is formed against the background of:
- Injuries to the femur - falling on the thigh, hitting something, prolonged stay of a person on one side of the body in a horizontal position.
- Periodic excessive loads on the hip joint - when climbing stairs, jogging for long distances, cycling, prolonged standing.
- Pathology can occur with a physiological deficiency - a different length of the legs, which has a direct effect on a person’s gait. In this case, synovial bags of the hip joint are subject to severe irritation.
- Bursitis can be the result of concomitant diseases, such as rheumatoid arthritis, pathologies of the spine (scoliosis), etc.
- Surgical intervention in the hip joint, as well as endoprosthetics, can become a trigger in the development of pathology.
- The presence in the body of deposits of calcium salts in the tendon of the greater trochanteric femur leads to irritation and inflammation of the synovial sac and, as a result, to bursitis.
- Hypothermia, lack of exercise (sedentary lifestyle), overweight - companions of bursitis.
It must be said that sometimes pathology occurs without any external causes.
Diagnostics. Inspection
A complex of methods is used in the diagnosis of hip bursitis. The specialist conducts a conversation with the patient, as a result of which he finds out the presence / absence of concomitant diseases, possible previous surgical interventions. Particular attention is paid to a thorough examination of the patient, taking into account all his observations. The specialist takes into account complaints of increased pain and sensitivity in the area of the protruding thighs.
Of all types of bursitis, trochanteric bursitis is most often found. This form of pathology is characterized by burning pain in the area of the hip joint. Pain can spread along the outer surface of the thigh. It is difficult for a patient to be on a side for a long time during rest or sleep. The pain syndrome intensifies with active movement - when walking, squatting, abrupt rotation of the thigh, climbing stairs.
If there was a bruised hip and severe pain - acute bursitis is suspected. Often the development of pathology as a result of trauma is preceded by a strong click, which patients notice. Sometimes medical workers are interested in the patient’s occupation, because the disease described is common among athletes.
Other examination methods
Since the hip joint is surrounded by a layer of muscle tissue, palpation of the hip area is performed at the first stage of examination and diagnosis. With this manipulation, the area in which pain is felt is revealed. Next, the position of the joint is determined, in which the pain syndrome acquires the greatest amplitude (the doctor moves the patient’s leg from side to side).
Often the diagnosis is clear at the examination stage, and additional diagnostics are not required, however, additional research methods may be prescribed to the patient in cases that are ambiguous and controversial, or to exclude possible injuries and other pathological manifestations.
For example, an X-ray with trochanteric bursitis reveals calcifications in soft tissues in the region of the greater trochanter. On the magnetic resonance tomogram, the inflammatory process of the trochanteric pouch and the accumulation of fluid in it are clearly visible. Performing an ultrasound scan also helps to identify excess fluid in the bag.
Bursitis treatment
The methods used in the treatment of bursitis depend on the period of the disease. So, in the initial stage of the disease, for the patient to recover successfully, he is required to exercise physiotherapy exercises, use anti-inflammatory drugs and observe the daily regimen, the main component of which is the patient’s complete rest and minimizing strong physical exertion and activity. To eliminate the symptoms of bursitis of the hip joint, drug treatment is started with the use of anti-inflammatory non-steroid drugs. It can be both oral preparations, and ointments, gels, for example, Diclofenac. Often, a 2% solution of novocaine is used in combination with hydrocortisone (glucocorticoid hormones) to relieve severe pain. The patient is advised to avoid movements that cause pain. After the pain syndrome is stopped, you can perform light physical exercises aimed at training and strengthening the gluteal muscle.
In advanced cases (if the above methods do not have the desired therapeutic effect), they resort to physiotherapeutic procedures - laser therapy, magnetotherapy, electroanalgesia, decimeter microwave therapy, naphthalan applications. Sometimes shock wave extracorporeal treatment is effective in treating bursitis.
The failure of these procedures will entail injections of drugs containing glucocorticoids (in the area of localization of the greatest pain), and sometimes to surgical intervention. The principle of surgery for trochanteric bursitis is to relieve tension of the ileo-tibial tract. Sometimes excision of the trochanteric joint bag is performed. The prognosis of recovery from such operations is overwhelmingly good.
Complications and rehabilitation
The main complication of trochanteric bursitis is considered to be the transition of the disease from acute to chronic. With chronic disease, in most cases, surgery is necessary - an operation.
As a rule, the symptoms of bursitis of the hip joint disappear after a few weeks at most. However, there are cases when the symptoms of the disease do not go away for several months, in which case we can say that the pathology has passed into the chronic stage. In this case, pain and restriction of the internal mobility of the thigh remain.
In the case when adhesive capsulitis is formed - inflammation of the capsule of the hip joint, the patient has a feeling of a “frozen” hip joint.
The left side of the picture illustrates an inflamed joint. In this case, a partial or complete violation of its mobility occurs. The right part of the picture reflects the healthy state of the capsule.
If there has been surgery, it is very important to undergo the necessary rehabilitation. During this period, it is recommended to use auxiliary means when moving - crutches, canes, walkers. This is especially true for the first days after surgery. However, it is necessary to start moving and getting out of bed already on the day of the manipulation itself. This contributes to the correct tissue repair. A few days after the operation, the pain syndrome that accompanies bursitis of the hip joint usually disappears.
Treatment with folk remedies
Treatment of bursitis with the help of traditional medicine recipes is aimed primarily at stopping the inflammatory process. In most cases, absorbable compresses are used for these purposes.
For example, with bursitis of the hip joint on a grater rub 1 tbsp. spoon of laundry soap, add there a spoon of honey, grated onions (1 tablespoon). The resulting mass is thoroughly mixed and laid on a cotton cloth. Compress is applied to the inflamed area, wrap with a woolen cloth, hold for 2-4 hours. Treatment is usually carried out for seven days.
There is another effective recipe for a compress that helps to eliminate the manifestation of the disease (bursitis of the hip joint), symptoms. Medicines are made on the basis of two glasses of alcohol mixed with a bottle of pharmacy bile, two glasses of horse chestnut and aloe. The resulting mixture can withstand a week and a half. Then the linen cloth dipped in the product is applied to the sore spot. Keep the compress from 3 to 4 hours. Treatment is carried out for ten days.
In order to get rid of bursitis, use a leaf of burdock, a leaf of cabbage. These herbal remedies have an antitumor (delaying) effect. Often, traditional medicine suggests using vegetable compresses from beets, potatoes, cabbage. The vegetable is rubbed on a fine grater and spread on a natural tissue with a layer of about 0.5-1 cm. The medical compress should cover the area of the edema (swollen area) completely. Treatment is carried out from 2 to 4 hours, during the week.
Summarizing all of the above, we can conclude that bursitis is a disease, the occurrence of which is due to a number of factors, namely: excessive physical exertion, previous surgical procedures, infectious pathogens. Pathology is treatable, however, it is important not to start the disease, and when the first manifestations of the disease appear, consult a specialist and start therapeutic procedures.
The article describes in detail what is bursitis of the hip joint. Symptoms, photos illustrating the manifestation of the disease, treatment methods are also highlighted in the materials of this topic.