Inflammation of the hip joint Inflammation of the hip

joint can be bacterial or sterile or rheumatic. Initially a synovial effusion is seen associated with a demineralization of subchondral bone. The periarticular soft tissues are swollen. Eventually the cartilage is destroyed in the total circumference of the joint (concentrically, Fig. 8.55a). Reactive synovial proliferation undermines the cartilage in the periphery of the joint and the typical erosions result. Toward the final stage of the disease, the joint is ankylosed or fused, making any movement impossible (Fig. 8.55b).

Avascular necrosis (AVN) of the femoral head: This entity is the consequence of a vascular insufficiency in an anatomical region that normally loses its embryological second arterial system because the vessels in the acetabular

I Intraosseous Ganglion Cyst

I Inflammation of the Hip Joint

I Intraosseous Ganglion Cyst

Erosion Femoral Head
Fig. 8.54 The large cyst in the acetabulum is well appreciated. As the joint seems to be absolutely normal otherwise, the cyst most likely represents an intraosseous ganglion cyst.

ligament obliterate. AVN may be idiopathic but it is frequently associated with steroid therapy, chemotherapy, liver cirrhosis, and alcoholism. The contour of the femoral head collapses (Fig. 8.56a) and an accelerated osteoarthritis of the hip ensues. MRI detects bone marrow edema associated with femoral head necrosis much earlier than any other method and during a stage when treatment can still be of benefit (Fig. 8.56b), which is why it is indicated in hip pain with no other detectable reason.

Inflammation Hip Joint

Fig. 8.55a An inflammatory process, either rheumatic or infectious, is the cause for this acute joint condition. The cartilage in the hip joint has been destroyed completely and everywhere. There are no osteophytes at all. The acute phase of the arthritis has passed—the bone is already remodeling with reactive sclerosis. b On this radiograph of the hip, the trabeculae of the femoral head are seen to run through into the acetabulum with no joint space discernible except in the medial periphery of the joint. This hip joint has become fused/ankylosed in a late and final phase of the arthritis.

Fig. 8.55a An inflammatory process, either rheumatic or infectious, is the cause for this acute joint condition. The cartilage in the hip joint has been destroyed completely and everywhere. There are no osteophytes at all. The acute phase of the arthritis has passed—the bone is already remodeling with reactive sclerosis. b On this radiograph of the hip, the trabeculae of the femoral head are seen to run through into the acetabulum with no joint space discernible except in the medial periphery of the joint. This hip joint has become fused/ankylosed in a late and final phase of the arthritis.

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Responses

  • NEGISTI
    What is a intraosseous ganglion cyst in the hip?
    2 years ago

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