Other Disorders of the Skeletal System - Pelvis and hip disorders

The hip joint presents most of the problems in the pelvic area. Symptoms may appear in early infancy in the form of congenital hip dislocation, in older children as tuberculous and transient arthritis, as slipped epiphysis in young adults (discussed below), and as osteoarthritis in adults and the aged. Early diagnosis of these conditions is very important in reducing the possibility of permanent deformity.

Diagnosis is achieved by physical examinations for signs of abnormal joint stability and mobility, postural changes, unstable and painful hip movement, fixed joint deformity, and pain in the lower back. Measurement of both lower limbs may indicate the presence of abnormal hip structure. X-ray examination of the pelvic area and both hips aids in diagnosis, as does blood analysis, which may yield evidence of early signs of gouty or arthritic conditions.

Slipped Epiphysis

This condition occurs in late childhood, between the ages of 9 and 18. The head of the femur , or thighbone, slips from its normal position, affecting one or both hips. The individual feels pain in the hip and knee, has limitation in joint movement, and walks with a limp. Usually there is evidence of endocrine disturbances.

Legg-Perthes’ Disease

This is an inflammatory condition of unknown origin involving the bone and cartilage of the femoral head. It is found mostly in children between 4 and 12 years old and usually affects one hip. The symptoms are thigh and groin pain, joint movement limitation, and a walking impediment.

Successful treatment requires extended hospitalization with weight traction applied to the diseased hip and limitation of body weight on the affected side. Untreated Legg-Perthes’ disease leads to permanent hip joint deformity and possible osteoarthritis around middle age.

Coxa Vara

This hip deformity is caused by a misshapen femur and causes shortening of the leg on the affected side; as a result, the person walks with a limp. The condition may be related to bone softening brought on by rickets, poorly joined fractures of the hip, or congenital malformation of the hip joint. Some cases may require surgical correction.

Any attack of persistent unexplained hip pains, limitation of movement, and walking impediments should be referred to the family physician for further investigation. Early diagnosis is crucial in controlling and eradicating many of the crippling diseases of the pelvic area.

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