Inflammatory Arthritis of the Hip
What is it: Inflammatory condition of the hip caused by systemic disorders.
How does it present: Patients often present with pain in the anterior groin. Stiffness is common and my improve with some activity, but overall pain may increase with more intense activity.
Common exam findings: Patients often have an antalgic gait and may develop a Trendelenberg gait with progression of the disease. Pain and loss of internal rotation is the most common finding on examination although general range of motion may also be compromised. The Faber (Patrick) Test is usually positive.
Tests and treatment: AP views of the pelvis as well as AP and lateral radiographs of the hip may show bony erosions and joint space loss. Laboratory studies to evaluate for systemic inflammatory disease processes should be considered as should diagnositic joint aspiration if there is an effusion. Appropriate treatment depends on modifying the causitive systemic disorder, usually manged with a rheumatologist. Conservative treatments such as appropriate weight managment, physical therapy and assistive walking devices as well as hip replacement can be considered similar to treament of osteoarthritis.