Arthritis of the Hip Joint

If you are experiencing hip problems, you may have arthritis. Here are commonly asked questions about arthritis and the hip joint. 

What is hip arthritis?

Arthritis is the roughening and destruction of the cartilage that lines the ball and socket. These rough surfaces generate friction and inflammation, causing pain and stiffness.

Does hip arthritis always develop with old age?

Most people never develop hip arthritis, no matter their age. That said, everything in the body wears down with age, and hip cartilage is no exception. Those who need hip replacement surgery generally have a faster progression of hip arthritis because of injury, underlying inflammatory problems, genetic predisposition to arthritis or a congenital abnormality of the hip joint.

Comparison of healthy versus worn cartilage in the hip joint

What is osteonecrosis (avascular necrosis)?

Osteonecrosis literally means “dead bone.” Some people can lose circulation into the ball of the hip joint causing the bone to weaken, the ball to collapse and change shape and the hip joint to degenerate. The dead bone condition can be painful on its own. Arthritis that develops after the femoral head has been mis-shaped for a long time can also be a source of pain.

Where do you feel the pain of an arthritic hip?

Most people feel hip pain in their groin or front of the thigh. Less commonly, it may be in their buttock or knee.

Can hip pain be coming from other places?

Yes. There are other problems that may cause pain around the hip or pelvis. The most common are degeneration of the spine, inflammation of nerves from the lower back (spinal stenosis), degeneration of the joint between the spine and pelvis (sacroiliac joint), inflammation of tendons attaching to the side of the hip (trochanteric bursitis) or tendonitis around the front of the hip (iliopsoas tendonitis).

About 20% of patients will have symptoms affecting two areas at the same time. This is most commonly the back and the hip. Hip replacement surgery may help one source of pain, but the other condition also may need treatment.

How is arthritis or degeneration of the hip joint diagnosed?

x-ray of hip used to diagnose arthritis or degeneration of the hip joint

In most cases, a diagnosis can be made by X-ray and a physical examination. Damage to the hip creates a narrowing of the space between the ball and socket. Eventually, the hip can lose so much cartilage that bone touches bone, which can be very painful. Some patients have a painful hip that is caused by other structural problems with the hip joint. These structural problems usually can be diagnosed with a physical examination and X-rays, but sometimes more advanced imaging, such as MRI, can help identify other pain causes.


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