Idiopathic Chondrolysis Of Hip Research Articles

Minimally invasive treatment for idiopathic chondrolysis of the hip: analysis of forty-one cases.

Idiopathic chondrolysis of the hip is characterized by the loss of the articular cartilage of the hip joint with spectrum ranging from full recovery to fibrous ankylosis. Study assessed outcomes following intra-articular steroid injections, joint manipulation and traction immobilization. Retrospective (2012-2021) review of 41 cases treated for idiopathic chondrolysis of hip, assessed pre-operatively and post-operatively (minimum 2-year follow-up) using Children's Hospital Oakland Hip Evaluation Score (CHOHES), visual analogue scale (VAS) and range of motion measurements. Twenty-five patients (62%) achieved painless mobility, 6 (14%) had hip stiffness without pain and 10 (24%) had painful and stiff hips at final follow-up. They had a mean age of 12.49 ± 2.4years and a mean follow-up duration of 33.15 ± 13.1months. Range of motion improved significantly (p < 0.05). VAS improved to 3.93 ± 1.3 from 7.8 ± 0.7. CHOHES improved from 29.12 ± 9.9 to 56.37 ± 17.6. Intra-articular steroid injection, manipulation and traction immobilization may effectively treat idiopathic chondrolysis of the hip by enhancing patient function and reducing the need for further surgical intervention.

Idiopathic chondrolysis of hip: A case report with literature review

Idiopathic chondrolysis of the hip (ICH) is a rare debilitating disease that results in articular cartilage loss in proximal femoral epiphysis and acetabulum; in the absence of a history of trauma, slipped capital femoral epiphysis, Perthe’s disease, prolonged immobilization, and infective/inflammatory joint diseases or malignancies. The diagnosis of chondrolysis of the hip is usually delayed due to the gradual onset of symptoms, initial normal radiographs, and the absence of specific diagnostic laboratory tests. Magnetic resonance imaging is the gold standard for the early diagnosis and grading of disease. ICH is often reversible with non-surgical management such as rest, alleviation of pain, and avoidance of weight-bearing. The clinical details and imaging appearance of this uncommon disease are discussed here.

A conservative approach towards idiopathic chondrolysis of hip: a case report

Chondrolysis of the hip causes pain and a limping as articular cartilage space is gradually lost due to an unknown but suspected inflammatory process. It could be idiopathic or due to another hip condition, such as slipped capital femoral epiphysis. It is a well-known complication of a slipped capital femoral epiphysis, although it can also occur as a result of trauma, septic arthritis, immobilization, or juvenile idiopathic arthritis. Idiopathic chondrolysis of the hip is a disorder that causes the articular cartilage of the hip joint to degrade spontaneously. The most common clinical manifestation is pain at the affected hip joint, which is linked to increasing joint stiffness and a significant loss of range of motion and function. Idiopathic chondrolysis of hip is a rare condition with Incidence around 8.2% percent. In this case report we are presenting a 12-year-old boy came with complaint of pain, stiffness and restricted range of movement at left hip joint followed by trauma. On the basis of physical and investigatory findings, the patient was diagnosed as a case of idiopathic chondrolysis of hip associated with avascular necrosis grade 4 according to Ficat and Arlet classification. Radiological findings were evident of reduced joint space of left hip and slipped capital epiphysis, this is known to be the hallmark finding to confirm the diagnosis of idiopathic chondrolysis of hip. The patient was conservatively managed with non-steroidal anti-inflammatory medicines, vigorous physiotherapy. Chrondolysis is usually managed with bed rest, traction and non-steroidal anti-inflammatory drugs, hence the aim of this case report was to incorporate an elaborate and efficiency of physical Therapy along with medical management to promote the recovery, aid early return to activities of daily living and improve quality of life.

Idiopathic chondrolysis of hip in children: New proposal and implication for radiological staging.

Purpose:Our objective was to evaluate the radiological appearances in different stages of idiopathic chondrolysis of hip (ICH) which will be helpful in the early diagnosis and guiding appropriate treatment for this condition to prevent progression of disease.Materials and Methods:We evaluated 14 patients of ICH in varying stages: Stage 1 (n = 9), Stage 2 (n = 3), Stage 3 (n = 2). Average age at presentation was 10–11 years. Plain radiograph and magnetic resonance imaging (MRI) was done in all these patients.Results:In the current study, we have attempted to stage ICH based on the radiological progression of the disease, where MRI was used as the primary tool. Stage 1 showed a wedge-shaped hyperintensity in T2 weighted (T2W) and hypointensity in T1 weighted (T1W) images involving the middle one-third of the femoral head and it is the earliest and characteristic finding in MRI. Associated findings like joint space narrowing, synovial hypertrophy with joint effusion may also be observed. Stage 2 showed acetabular edema in the affected hip in addition to the above-mentioned findings. Stage 3 showed more extensive involvement of femoral head and acetabulum, with collapse of the femoral head, degenerative changes in hip, early osteoporotic changes, and ultimately loss of joint space.Conclusion:Imaging-based staging system proves very useful in the early diagnosis, staging, and assessing the prognosis of ICH.

Idiopathic chondrolysis of hip: a case report

Idiopathic chondrolysis of the hip is a rare condition occurring mainly in adolescents and is characterised by a rapidly progressive destruction of the articular cartilage. A male patient aged 18 years presented to us with pain in his left hip, restriction of movements, and limping due to pelvic obliquity. On examination patient had severe tenderness over left hip, fixed flexion and abduction deformity were present and all movements were painful. Radiographic imaging showed narrowing of joint space, irregular blurring of subchondral sclerotic lines and femoral neck widening. MRI scan depicts marrow changes earlier than any other imaging method. Biological markers for inflammation and infections have been studied, which was normal. To achieve mobile hip, for this patient we planned for Total hip replacement after confirming our diagnosis. Idiopathic chondrolysis of the hip is a rare clinical entity where, unfortunately, there is often a delay in diagnosis. There are characteristic clinical and radiological features but no effective therapy to arrest the disease. Until today no evidence concerning the aetiology of ICH has been presented. Therefore the treatment is mainly symptomatic. Conservative treatment focuses on pain control and preservation of joint mobility. Physiotherapy seems to be important to preserve a good range of motion. In addition most authors agree to unload the affected hip joint by means of bed rest and skin traction. Published results of surgical treatment are not conclusive and arthroplasty in young patients is controversial. There is no consensus on the treatment algorithm. Recommended surgical treatments include corrective osteotomy, bony fusion or joint arthroplasty. Awareness of the existence of this disease will lead to earlier diagnosis and management.

Idiopathic chondrolysis of hip

An uncommon case of idiopathic chondrolysis of the hip in an 11-year-old girl is reported. It was characterized by clinical presentation, laboratory tests, and imaging techniques. A differential diagnosis is discussed highlighting the radiological features for quick diagnosis.