La hanche abarticulaire

Abstract

The abarticular hip now benefits from a powerful imaging that allows to better specify the structure in question and the degree of its lesion, which leads to a more effective therapeutic management. But this very widely performed imaging also shows asymptomatic lesions that make the radioclinic correlation more essential than ever, which implies not to skip the fundamental step of the clinical examination, even if it can be complicated by the association of several pathologies, which is quite common in the hip area. The tendinopathies of the gluteus medius and minimus, better diagnosed and which dominate in frequency the periarticular pathology of hip, thus took precedence over the bursopathies which accompany them. Other tendons and bursae around the hip should not be ignored, such as the iliotibial tract with proximal enthesopathy of the iliotibial tract on the iliac crest and its recently discovered corporeal peritrochanteric pathology, iliopsoas and the pathology of its bursae, the rectus femoris, not only by its direct tendon, but also its indirect tendon and the proximal hamstring tendons, the pathology of which affects not only sportsmen, but also the elderly, where these tendinopathies are often ignored. Finally, a new syndrome, the ischiofemoral impingement comes to enrich this periarticular pathology too long focused on the anterior and lateral aspect of the hip to the detriment of this posterior hip area of difficult clinical analysis. The development of hip replacement surgery with the most often remarkable results, however, generates a periarticular pathology that the rheumatologist must know, helped also by an imaging in progress.