Inflammations of the hip joint are categorized according to cause and progression as follows:

1. Infectious Coxitis:

- Bacterial, viral, or rarely fungal infections that directly enter the joint.

2. Rheumatic Coxitis:

- Inflammation due to autoimmune diseases such as rheumatoid arthritis or ankylosing spondylitis.

3. Reactive Coxitis:

- Inflammatory reaction following infections in other parts of the body, e.g., after a gastrointestinal infection.

4. Degenerative Coxitis:

- Inflammations caused by advanced osteoarthritis or overuse of the joint.

The causes of hip joint inflammation are diverse and include:

• Infectious causes:
  • Bacteria such as Staphylococcus aureus or streptococci enter the joint through the bloodstream, injuries, or surgical procedures.
  • Viral infections, e.g., caused by Coxsackie viruses, can also inflame the hip joint.
• Rheumatic diseases:
  • Rheumatoid arthritis, lupus erythematosus, or ankylosing spondylitis lead to chronic inflammation in the hip joint.
• Mechanical overload:
  • Excessive strain on the joint, e.g., from sports or overweight, can trigger an inflammatory reaction.
• Reactive causes:
  • Infections such as urinary tract infections or gastrointestinal infections lead to secondary hip inflammation through immunological processes.
• Traumatic causes:
  • Injuries to the hip joint, such as bruises or fractures, promote inflammation.

The symptoms of a hip joint inflammation vary depending on the cause and severity:

- Pain:

- Typically, there is pain in the groin area, which can radiate to the thigh or buttocks.

- Movement restrictions:

- Difficulties in walking, bending, or rotating the leg.

- Swelling and warmth:

- Visible swelling and overheating in the hip joint area, especially in infectious coxitis.

- Fever:

- Accompanying fever often occurs with infectious inflammations.

- Protective posture:

- Affected individuals often adopt a protective posture to avoid pain.

- Chronic complaints:

- In rheumatic causes, symptoms occur in episodes and can persist permanently.

The diagnosis of hip joint inflammation is based on medical history, clinical examination, and imaging techniques:

• Medical history:
  • Collection of medical history, possible infections, or pre-existing conditions.
• Clinical examination:
  • Checking for pain points, mobility, and signs of inflammation.
• Imaging techniques:
  • X-ray: To assess joint changes or osteoarthritis.
  • Ultrasound: Visualization of joint effusions and soft tissue changes.
  • MRI: Precise examination of the joint in case of unclear diagnosis.
• Laboratory diagnostics:
  • Blood tests for inflammation markers (CRP, ESR) and infectious agents.
  • Joint puncture to analyze joint fluid in suspected infectious coxitis.

Conservative Therapy

Most hip joint inflammations can be treated without surgery:

• Antibiotics:
  • For bacterial infections to combat the pathogens.
• Pain and anti-inflammatory medication:
  • Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen to relieve pain and inflammation.
• Physiotherapy:
  • Mobilizing and stabilizing exercises to improve joint function.
• Cold or heat applications:
  • Cooling for acute inflammation or heat to relax tense muscles.
• Immobilization:
  • Short-term relief of the hip joint using walking aids or splints.

Surgical Therapy

In severe or therapy-resistant cases, surgical intervention may be necessary:

• Arthroscopic joint lavage:
  • Removal of inflamed tissue or joint effusions.
• Joint prosthesis:
  • Replacement of the hip joint in cases of irreparable damage due to osteoarthritis or infections.

To prevent hip joint inflammations, the following measures are recommended:

1. Early detection of infections: Treatment of infections in the body before they can spread to the joint.
2. Weight reduction: Relieving the hip joint through weight management.
3. Regular exercise: Promoting joint health through joint-friendly sports such as swimming or cycling.
4. Ergonomic posture: Avoiding poor posture and overloading in everyday life.
5. Education and prevention: Regular medical check-ups for known underlying conditions such as rheumatism.