Unilateral thigh atrophy and weakness in hip osteoarthritis

Severe Atrophy of the Ipsilateral Psoas Muscle Associated with Hip Osteoarthritis and Spinal Stenosis-A Case Report

Pathology of the lumbar spine and hip joint can commonly coexist in the elderly. Anterior and lateral leg pain as symptoms of hip osteoarthritis and spinal stenosis can closely resemble each other, with only subtle differences in both history and physical examinations. It is not easy to identify the origin of this kind of hip pain. The possibility of hip osteoarthritis should not be underestimated, as this could lead to an incorrect diagnosis and inappropriate spinal surgery. We report the case of a 54-year-old female with chronic right anterior and lateral leg pain who did not respond to repeated spinal blocks based on lumbar MRI, but in whom hip osteoarthritis was considered since severe atrophy of the ipsilateral psoas muscle was identified. We suggest that severe psoas muscle atrophy can be a clinical clue to identify hip osteoarthritis and is related to lower extremity pain, even if there is a coexisting lumbar spine pathology.

Hip surgery candidates: a comparative study of hip osteoarthritis and prior hip fracture patient characteristics

Aim:

To assess similarities and differences in patient-related characteristics before and after surgery for painful disabling hip osteoarthritis among elderly subgroups with and without a trauma history.

Method:

First, a cohort of 1000 hospitalized patients were assessed for trends in: perceived duration of the condition, pain intensity, functional performance ability, walking distance, body mass, and comorbidity characteristics among other factors. Then, the most salient of these patient-related characteristics were compared between 42 cases of hip osteoarthritis without a trauma history and 42 cases with a trauma history matched for age and gender, using medical records and standard data recording and analysis procedures.

Results:

Hip osteoarthritis cases with a prior hip fracture history had a longer duration of disability, and were more impaired functionally before surgery (p < 0.05) than those with no such history. They also had lower leg muscle strength and used more assistive devices.

Conclusion:

Patients undergoing hip replacement surgery for painful hip osteoarthritis who have a hip fracture history are likely to be more impaired and disabled than those with no such history.