Which types of arthritis affect the hip?

Arthritis affecting the hip falls into two groups: osteoarthritis, in which the cartilage wears with age, load or injury, and inflammatory types such as rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis. Crystal diseases such as gout and joint infection can also cause arthritis.

What are the causes and risk factors?

Its development depends on several factors: older age, a family history, excess weight, heavy and repetitive loading, previous hip injuries and developmental problems such as dysplasia and impingement. In inflammatory arthritis the immune system, and in osteonecrosis a blood-supply problem, damage the joint surface.

What are the symptoms?

The main symptoms are dull, aching pain in the groin, hip, thigh or knee, stiffness after sleep and rest, reduced range of motion and a limp. An important feature of hip-related pain is that it is usually felt in the groin and can spread to the knee.

How is hip arthritis diagnosed?

The diagnosis begins with the history and examination; an X-ray shows narrowing of the joint space and loss of cartilage. Blood tests for ESR, CRP and rheumatological markers are used when inflammatory arthritis is suspected, and MRI when early cartilage damage or osteonecrosis is suspected.

Treatment usually begins without surgery: weight control, activity modification, physiotherapy and pain management; in inflammatory arthritis, disease-modifying drugs together with rheumatology. Injections are considered in selected patients; the role of biologics such as PRP and stem cells is limited and still under research.

When is surgery needed, and can it be prevented?

Surgery comes onto the agenda in advanced stages where pain persists despite non-surgical treatment and clearly limits daily life; total hip replacement is the most common option. Arthritis cannot be prevented entirely, but weight control, low-impact exercise and early treatment can slow its progression. See a doctor if pain lasts for weeks, or there is swelling in more than one joint or fever.

Hip Arthritis: Symptoms, Diagnosis and Treatment

Q: What is hip arthritis?

Hip arthritis is a group of conditions in which the cartilage of the hip joint wears down or becomes inflamed, causing pain, stiffness and restricted movement. The most common type is osteoarthritis, which develops through mechanical wear; in inflammatory arthritis the problem is the immune system turning against the joint.

Q: How is hip arthritis told apart from other hip pain?

Arthritis is not the only cause of pain around the hip. Pain on the outer side that increases with pressure over the bony prominence usually comes from bursitis and a tendon problem, whereas in arthritis the pain is deep in the groin and increases with rotation and squatting. Pain that spreads to the lower back and leg with numbness suggests nerve compression from the spine.

What is Hip Arthritis?

What Is Hip Arthritis?

Hip arthritis refers to a group of conditions in which the cartilage of the hip joint wears down or becomes inflamed over time, causing pain, stiffness and restricted movement. The hip is a joint in which the femoral head (the ball) sits in the acetabulum (the socket); when the cartilage covering the surfaces wears away, bone works closer to bone and symptoms appear.

The most common type is osteoarthritis, which develops through mechanical wear of the cartilage. In inflammatory arthritis the problem is the immune system turning against the joint. The two differ in cause and treatment approach, so the correct type is identified. For other hip problems you can review the hip page.

Types of Hip Arthritis

Arthritis affecting the hip falls mainly into two groups; this distinction determines the direction of treatment.

Osteoarthritis: wear of the cartilage with age, excess load or a previous injury. It is the most common type.
Inflammatory arthritis: immune-driven diseases such as rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis; these often involve more than one joint.
Other causes: crystal diseases such as gout, joint infection (septic arthritis) and post-traumatic arthritis.

Causes and Risk Factors

Several factors influence the development of hip arthritis, and some of them can be modified.

Older age and a family history of hip arthritis.
Excess weight and heavy, repetitive loading that strains the joint.
Previous hip injuries, fractures and developmental hip problems (dysplasia, impingement).
The immune system turning against the joint in inflammatory arthritis; blood-supply problems such as osteonecrosis can also damage the joint surface.

Symptoms

Symptoms usually begin insidiously and increase over time. An important feature of hip-related pain is that it is usually felt in the groin and can sometimes spread to the knee.

Dull, aching pain in the groin, hip, thigh or knee.
Stiffness in the morning or after prolonged sitting and difficulty getting going.
Reduced range of motion; difficulty with movements such as putting on socks and tying shoes.
A limp, a shorter walking distance and, in advanced stages, night pain.

Conditions That Can Be Confused With It

Arthritis is not the only cause of pain around the hip; examination and imaging tell them apart. Pain on the outer side of the hip that increases with pressure over the bony prominence usually comes from bursitis and a tendon problem, whereas in arthritis the pain is deep in the groin and increases with rotation and squatting.

Pain that spreads to the lower back and leg with numbness suggests nerve compression from the spine. When the hip causes groin pain but the knee examination is normal, the source of the pain is the hip; these distinctions change the treatment directly.

Diagnosis: Examination and Tests

The diagnosis begins with the history and physical examination. The range of motion of the hip, painful positions and the gait are assessed; the duration of the complaint and its pattern through the day are asked about.

X-ray: the basic study that shows narrowing of the joint space, loss of cartilage and bone changes.
Blood tests: ESR, CRP and rheumatological markers are requested when inflammatory arthritis is suspected.
MRI: used when early cartilage damage, osteonecrosis or an accompanying soft-tissue problem is suspected.

Non-Surgical Treatment

Treatment usually begins with non-surgical measures. The aim is to reduce pain, preserve function and keep the patient's own joint for as long as possible.

Weight control and activity modification: reducing movements that strain the joint and switching to low-impact activities.
Pain management: anti-inflammatory medication under medical advice; in inflammatory arthritis, disease-modifying drugs (DMARDs/biologics) together with rheumatology.
Physiotherapy: strengthening the hip and trunk muscles, preserving range of motion and, where needed, aids such as a cane.

Injections and Biologic Treatments

In selected patients, intra-articular injections may be considered to reduce pain. A corticosteroid injection can temporarily reduce inflammation and pain; its effect varies between patients and over time.

The role of biologic treatments such as PRP and stem cells in hip arthritis is still being researched; the evidence is limited and heterogeneous, these methods do not regrow cartilage and they are not offered as routine treatment. These options are assessed on an individual basis, with realistic expectations and clear information.

When Is Surgery Needed?

Surgery is considered in advanced arthritis where pain persists despite non-surgical treatment and clearly limits daily life and sleep. The most commonly used method is total hip replacement; the damaged joint surfaces are removed and replaced with an artificial joint.

In certain early stages of inflammatory arthritis, procedures such as removing the joint lining (synovectomy) may come onto the agenda in selected cases. The decision is made on an individual basis according to the type and stage of arthritis and the patient's age and expectations; infection and general health are assessed before surgery.

Prevention and Daily Life

Arthritis cannot always be prevented entirely; however, habits that reduce the load on the joint help slow progression and preserve function.

Keeping a healthy weight and maintaining low-impact activities such as swimming and cycling.
Strengthening the muscles around the hip regularly and preserving range of motion.
Treating developmental hip problems and injuries early and adhering to treatment in inflammatory arthritis.

When Should You See a Doctor?

Having hip pain assessed early allows the correct type to be identified and appropriate treatment to be started in good time.

Your groin or hip pain has lasted for weeks and affects your walking and daily activities.
Morning stiffness, restricted movement or a limp is steadily increasing.
There is swelling and pain in more than one joint, fever or sudden severe joint pain; these suggest inflammatory or infectious arthritis.

For the assessment of hip symptoms you can contact Assoc. Prof. Serkan Sürücü, and you can also review the other conditions covered within hip surgery.

Hip Arthritis