Anatomy:The hip joint consists of the hip socket and the femoral head (caput femoris). The articular surface is covered with a few mm thick cartilage layer, which reduces the load on the articular surfaces
Cause: In case of repeated loads, the cartilage primarily, and subsequently the bone below the cartilage, can be damaged (degenerative arthritis). The degenerative arthritis changes can in some cases cause an inflammation of the synovial membrane (synovitis) which causes fluid formation, swelling, movement restriction and pain in the hip joint.
Symptoms: Pain in the hip joint upon movement with load. There will often be movement restriction upon rotation in the hip joint.
Examination: Ordinary clinical examination is often sufficient to make the diagnosis. The examination can be supplemented with an X-ray examination. Ultrasound scan is the most suitable examination if you suspect a fluid accumulation in the hip joint.
Treatment: The treatment primarily comprises relief from the pain inducing activity until any swelling in the hip joint has decreased. Rehabilitation can subsequently be commenced with the primary goal to strengthen the muscles around the hip joint and preserve the joint mobility. There is no treatment that can restore the ruined cartilage (and bone). Cartilage transplants are not yet suitable for general degenerative arthritis changes. Upon swelling in the hip joint you can attempt to reduce the synovitis with rheumatic medicine (NSAID) or by attempting to drain the fluid and injecting corticosteroid, which should be conducted with ultrasound guidance to optimise the effect and minimize the risk. Pain without joint swelling is best treated with paracetamol. In cases of severe degenerative arthritis changes with pain when resting (at night) it may be necessary to replace the hip joint.
Complications: Degenerative arthritis which sits on the weight bearing parts of the joint is one of the most serious sports injuries, and often results in a termination of active sport. Cycling and swimming are significantly less stressful for the hip joint than running. In particular the following should be considered: