Utilisation of exercise as part of guideline-based care for hip pain in the Australian workers’ compensation environment

Work ◽  
2020 ◽  
Vol 67 (4) ◽  
pp. 971-978
Author(s):  
Darren Beales ◽  
Matthew Fulco ◽  
Eivor Gullhaugen ◽  
Aaron Peden ◽  
Stephen Ranford ◽  
...  
Keyword(s):  
Median Time ◽  
Hip Joint ◽  
Joint Pain ◽  
Diagnostic Category ◽  
Hip Pain ◽  
Workers Compensation ◽  
Post Injury ◽  
Early Referral ◽  
Retrospective Audit ◽  
Lateral Hip Pain

BACKGROUND: Guidelines recommend early referral for exercise for hip pain. It is unclear if this occurs in the Australian workers’ compensation environment. OBJECTIVE: To investigate referral for exercise in workers with a compensable hip claim. METHODS: Retrospective audit of closed compensation files for workers with hip pain was performed. Exercise commencement was indicated by billing codes for physiotherapy or exercise specific consultations. Time to exercise commencement was calculated. Associations were analysed between time to exercise commencement with claim duration and diagnostic category. RESULTS: Exercise management occurred for 33/44 cases. Median time to commence exercise for those cases that had exercise was 14 days post-injury, with 33% commencing beyond 4 weeks. Longer time to commence exercise was associated with a longer claim duration (Spearman’s rho = 0.70). Workers with a diagnosis of hip joint pain had a longer time to exercise commencement (median 49.5 days) compared to those with a diagnosis of lateral hip pain (median 14 days) or non-specific hip pain (median 4.5 days). CONCLUSION: Findings indicate practice behaviours in the workers’ compensation environment for the management of hip pain with exercise. Further investigation is warranted to see if improved adherence to guideline recommendations improves outcomes for people with compensable hip pain.

scholarly journals Role of magnetic resonance imaging as a diagnostic tool in evaluation of painful hip joint, and early detection of pathological changes, helpful to prognosticate and influence therapeutic decisions

2018 ◽  
Vol 5 (6) ◽  
pp. 1352
Author(s):  
Johny Prasad Bollipo ◽  
Pasupuleti Bhimeswara Rao
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Early Detection ◽  
Hip Joint ◽  
Joint Pain ◽  
Imaging Modality ◽  
Hip Pain ◽  
Pathological Changes ◽  
Resonance Imaging ◽  
Painful Hip

Background: Magnetic Resonance Imaging (MRI) is a well-established imaging technique, which are available at most larger hospitals today. Due to the combination of this high contrast and the fact that it is a non-ionizing radiation, MRI is often used for investigation of a large range of pathologies in almost all parts of the body. This study was performed to describe the MRI features in various types of lesions causing painful hip joint, as well as identify the common lesions seen in painful hip joint and to analyse the severity and extent of the underlying lesion in various conditions of hip joint pain, and early detection of pathological changes helpful to prognosticate and influence therapeutic decisions.Methods: This descriptive study was done on 50 patients with complaints of hip joint pain were included into the study. Appropriate MRI sequences and multi-planar imaging performed for every patient.Results: Out of the 50 patients included in the study, 74% of them were males who were predominantly affected with hip pain. The most common age group which was affected was 51-60 years (20%) and 21-30 years (20%). The most common pathology amongst the patients was Avascular necrosis of femoral head seen in 44% of the patients, osteoarthritis was seen in 54 patients, Tuberculosis in 5 patients, 2 had Perthe’s disease, joint effusion was observed in 6 patients.Conclusions: MRI of the hip joint is an informative, diagnostic, non-invasive, rapid and accurate imaging modality for the assessment of hip pain and sufficient imaging modality for delineation of different hip joint pathology.

AB0691 CHARACTERIZATION OF DIFFERENT GROUPS WITH IMAGING AND NON-IMAGING FINDINGS OF ANKYLOSING SPONDYLITIS COMBINE WITH HIP LESION IN WESTERN CHINESE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1640.1-1641
Author(s):  
Q. Han ◽  
Z. Zheng ◽  
K. Zhang ◽  
Z. Yu ◽  
F. Yang ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Hip Joint ◽  
Joint Pain ◽  
Hip Pain ◽  
Active Group ◽  
Western China ◽  
Hla B27 ◽  
Research Support ◽  
Chronic Group

Background:Hip joint lesion are the main cause of disability in patients with Ankylosing Spondylitis(AS) in western China. Seriously affect the quality of life of patients.The early clinical characteristics of hip joint disease are not typical, the disease is insidious, and the radiological diagnosis is delayed.The main prevention is early screening and early diagnosis.Objectives:This study attempted to find out the main characteristics and related factors in different groups of AS combine with hip joint lesion in western China.Methods:A-First evaluation:How many patients have 1) active SIJ changes on MRI. 2) chronic SIJ changes (each for erosion, clerosis, ankylosis, or any of those) on MRI. 3) a combination of active changes and chronic changes (each for erosion, sclerosis, ankylosis, or any of those) on MRI. 4) active hip changes on MRI. 5) chonic hip changes (erosion, effusion any of those) on MRI. 6) a combination of active changes and chronic hanges (erosion, effusion any of those) on MRI. B-Then, combination SIJ / hip. 7) active SIJ changes on MRI and in parallel active hip changes on MRI. 8) chronic (see above) SIJ changes on MRI and in parallel active hip changes on MRI. 9) chronic (see above) SIJ changes on MRI and in parallel chronic (see above) hip changes on MRI. 10) chronic (see above) SIJ changes on MRI and in parallel any (active or chronic) hip changes on MRI. C-Then, characterization of these groups with non-imaging findings. Characteristics of groups 7-10 above, for age, sex, Disease duration, Hip pain, Joint pain, enthesitis, Diarrhea, uveitis, ASDAS-CRP, BASDAI, BASFI, BASMI, Pat. Global, CRP, ESR, Harris Score, HLA-B27.Results:Retrospective analysis total 558 SpA patients (mean age 29, mean duration 5 years). 1) HIP-Active+Chronic group (N=288, AS=151) vs SIJ+HIP-Active group (N=241, AS=138): hip pain (p<0.0001), diarrhea (p<0.0001), joint pain (p<0.0001) and BASFI (p<0.05); 2) HIP-Active+Chronic(N=117, AS=58) vs SIJ-Chronic+HIP-Active group (N=214, AS=134): hip pain(p<0.0001), joint pain (p<0.0001), enthesitis (p<0.0001), ASDAS-CRP (p<0.05) and ESR (p<0.05); 3) SIJ-Active+Chronic group (N=204, AS=125) vs SIJ-Chronic+HIP-Active group (N=214, AS=134): hip pain (p<0.0001), joint pain (p<0.0001); 4) SIJ-Active+Chronic group (N=204, AS=125) vs SIJ+HIP-Chronic group (N=72, AS=40):hip pain (p<0.0001), Pat. Global (p<0.05); 5) SIJ+HIP-Active group (N=241, AS=138) vs SIJ-Chronic+HIP-Active group (N=214, AS=134): HLA-B27 positive (Chi-square, df, 24.98, 4) (p<0.0001); 6) SIJ+HIP-Chronic group (N=72, AS=40) vs SIJ-Chronic+HIP-Active/Chronic group (N=228, AS=144): Pat. Global (p<0.05), ESR (p<0.05).Conclusion:Hip joint lesion are closely related to sacroiliac joint lesion and HLA-B27 positive in AS. Hip pain is the main clinical manifestation of hip joint lesion in AS. Hip joint lesion may lead to function declines, disease activity in AS.References:[1]Vander C B, Munoz-Gomariz E, Font P, et al. Hip involvement in ankylosing spondylitis:epidemiology and risk factors associated with hip replacement surgery[J]. Rheumatology (Oxford), 2010,49(1):73-81.[2]Sieper J, Rudwaleit M, Baraliakos X, et al. The Assessment of SpondyloArthritis international Society (ASAS) handbook: a guide to assess spondyloarthritis[J]. Ann Rheum Dis, 2009,68 Suppl 2:i1-i44.[3]Ward M M, Deodhar A, Akl E A, et al. American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network 2015 Recommendations for the Treatment of Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis[J]. Arthritis Rheumatol, 2016,68(2):282-298.Disclosure of Interests:Qing Han: None declared, Zhaohui Zheng: None declared, Kui Zhang: None declared, Zheng Yu: None declared, Fengfan Yang: None declared, Qiang Liang: None declared, Ping Zhu: None declared, Xenofon Baraliakos Grant/research support from: Grant/research support from: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen, Consultant of: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen, Speakers bureau: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen

scholarly journals No Association Between Intrauterine Contraceptive Devices and Musculoskeletal Hip Joint Pain

2021 ◽  
Author(s):  
Nathan H. Varady ◽  
Paul Abraham ◽  
Michael P. Kucharik ◽  
Christopher T. Eberlin ◽  
David Freccero ◽  
...  
Keyword(s):  
Hip Joint ◽  
Joint Pain ◽  
Contraceptive Devices ◽  
Intrauterine Contraceptive ◽  
Intrauterine Contraceptive Devices

Role of MRI in Screening of Non-Traumatic Pediatrics Hip Pain

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Abeer Abd El Maksoud Hafez ◽  
Tarek Wahby Hameda ◽  
Ghadier Ibrahim Attia
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Hip Joint ◽  
Imaging Modality ◽  
Bone Cyst ◽  
Hip Pain ◽  
Joint Effusion ◽  
Resonance Imaging ◽  
University Hospitals ◽  
Great Ability

Abstract Background Magnetic resonance is the best imaging modality to assess hip joint in non-traumatic cases. It has a great ability to diagnose disorders of bone, cartilage, ligaments, muscles and soft tissue. MRI can also detect joint effusion and bone marrow edema. Aim of the Work: To assess the value of MRI as the imaging modality in children presenting with acute non-traumatic hip pain and its ability to assess the cause of the pain early without the use of another imaging modality. Patients and Methods A retrospective study was conducted on pediatric patients with non-traumatic hip pain, referred from the outpatient pediatric clinic, orthopedic clinic, Ain Shams University hospitals. The patients were investigated using magnetic resonance imaging (MRI) for detection the cause of non-traumatic hip pain. Results In this study we found that avascular necrosis is the commonest cause of non-traumatic hip pain followed by isolated hip effusion then synovitis. Other causes included perthes, septic arthritis, osteomyelitis, aneurysmal bone cyst, SCFE, PFFD and Osteomalacia. Magnetic resonance imaging doesn’t only demonstrate disorders of hip joint only; it also gives an accurate assessment of other extra-articular causes of referred hip pain. Conclusion Hip MRI is a practical, well accepted and accurate non-invasive imaging technique in children presenting with acute non-traumatic hip pain.

scholarly journals Pulsed Radiofrequency Application on Femoral and Obturator Nerves for Hip Joint Pain: Retrospective Analysis with 12-Month Follow-up Results

2018 ◽  
Vol 1 (21;1) ◽  
pp. 407-414 ◽  
Author(s):  
Andrea Tinnirello
Keyword(s):  
Retrospective Analysis ◽  
Hip Joint ◽  
Joint Pain ◽  
Pulsed Radiofrequency ◽  
Single Center ◽  
Medium Term ◽  
Post Procedure ◽  
Single Center Study ◽  
Center Study

Background: Osteoarthritis of the hip joint is a common cause of pain and disability. Patients not responding to conservative management often cannot undergo joint replacement due to the presence of multiple comorbidities, while some other patients prefer to postpone surgery as long as possible. Radiofrequency denervation of articular branches of the femoral and obturator nerves, which supply innervation of the joint, is a novel technique to reduce hip joint pain. Previous studies reported positive results after application of continuous radiofrequency to the target nerves; however, this approach carries the potential risk of neuritis and neuroma formation. Pulsed radiofrequency (PRF) is a safer alternative to continuous radiofrequency not creating necrosis but a complex neuromodulatory effect on target nerves. There is no published evidence of PRF efficacy after 3 month follow-up. Objectives: This single-center study objective was to evaluate the short and medium term effectiveness of PRF on the femoral articular branches and obturator nerves in patients with chronic hip pain. Study Design: Retrospective single-center study. Setting: Italian National Health Service Public Hospital. Methods: Retrospective analysis of 14 patients treated with PRF for severe hip joint pain (mean numeric rating scale (NRS) 7.7 ± 1.2 mean Oxford Hip Score (OHS) 20 ± 8.4). Mean pain and disability scores were evaluated with NRS and OHS respectively at 1, 3, 6, and 12-month follow-up. All patients were treated with pulsed radiofrequency applied under fluoroscopy on the articular branches of the femoral and obturator nerves for 300 seconds each. Results: Eight patients out of 14 (57%) reported an NRS reduction > 50% at 1 month post procedure. Overall, both pain and disability scores were significantly (P < 0.01) lower at all follow-up until 6 months, mean NRS at 1, 3, and 6 months was 3.6 ± 3; 4.1 ± 3.3; 4.8 ± 2.9 while OHS was 37.6 ± 17.7; 35.8 ± 17.7; 35.8 ± 14 respectively. At 12 months, NRS was 5.8 ± 2.4 while OHS 23.3 ± 12.7, it must be pointed out that even if both scores are significantly (P < 0.01) lower than basal, only 3 patients out of 14 (21%) maintained a NRS reduction > 50% from basal at 12 months post procedure. We reported 2 femoral artery punctures without any significant complication. Limitations: Retrospective study, small sample size. Conclusions: Pulsed radiofrequency is a safe and effective modality to treat hip joint pain in the short and medium term. Definition of positive outcome predictors is required to reserve radiofrequency treatment only for those patients who can benefit from this procedure. Key words: Hip joint pain, pulsed radiofrequency, obturator nerve, femoral nerve, interventional pain management, radiofrequency

scholarly journals Coxitis in early axial spondyloarthritis

2019 ◽  
Vol 13 (4) ◽  
pp. 41-47 ◽  
Author(s):  
E. M. Agafonova ◽  
T. V. Dubinina ◽  
D. G. Rumyantseva ◽  
A. B. Demina ◽  
A. V. Smirnov ◽  
...  
Keyword(s):  
Disease Activity ◽  
Hip Joint ◽  
Joint Pain ◽  
Rating Scale ◽  
Axial Spondyloarthritis ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Diagnostic Methods ◽  
Joint Movement ◽  
Joint Injury

In Russia, coxitis is one of the most common extra-axial manifestations of ankylosing spondylitis (AS). However, many issues regarding its early diagnosis remain unresolved.Objective: to compare the clinical manifestations of coxitis with the data from an instrumental examination of CoRSAR cohort (Cohort of Early Axial Spondyloarthritis) patients.Patients and methods. Examinations were made in 175 patients (mean age, 28.2±5.7 years) diagnosed as having axial spondyloarthritis (axSpA) with inflammatory back pain lasting up to 5 years, which occurred at the age of ≤45 years. There was non-radiographic axSpA (nraxSpA) in 69 patients and AS in 106 patients. 87% of patients were HLA-B27-positive. The median disease duration was 23.8 [1–60] months; BASDAI was 3.3±1.94. Regardless of complaints, all the patients underwent hip X-ray and ultrasound studies and 54 more patients had magnetic resonance imaging (MRI).Results and discussion. The clinical signs of coxitis were present in 95 (54%) patients, of them 60% were diagnosed with AS and 40% had nraxSpA. According to the numerical pain rating scale (NPRS), the median hip joint pain was 4 [3; 7]. Limited joint movement was observed in 6 (3.4%) patients. The level of hip joint pain correlated with BASDAI (r=0.53) and ASDAS (r=0.30). The ultrasound signs of coxitis were detected in 42 (24%) patients; of them 26 (62%) had the clinical manifestations of hip joint injury, and such changes were absent in 16 patients. The patients with ultrasound signs of coxitis were noted to have a higher disease activity; peripheral arthritis and enthesitis were more common. According to MRI, coxitis was diagnosed in 39 (72%) of the 54 examinees, while the disease was asymptomatic in 10%.Conclusion. Different diagnostic methods used in patients with early axSpA could reveal coxitis in 33% of cases. The patients with coxitis show higher laboratory disease activity than those without hip joint injury. It is necessary to include MRI and ultrasound in the mandatory examination of patients with axSpA.

scholarly journals Total Hip Arthroplasty for the Paralytic and Non-paralytic Side in Patient with Residual Poliomyelitis

2016 ◽  
Vol 10 (1) ◽  
pp. 105-110 ◽  
Author(s):  
Motoki Sonohata ◽  
Masaru Kitajima ◽  
Shunsuke Kawano ◽  
Masaaki Mawatari
Keyword(s):  
Muscle Strength ◽  
Total Hip Arthroplasty ◽  
Hip Joint ◽  
Hip Arthroplasty ◽  
Muscle Tone ◽  
Hip Osteoarthritis ◽  
Hip Pain ◽  
Total Hip ◽  
Early Results ◽  
History Of

Background: Total hip arthroplasty (THA) for poliomyelitis is a problematic procedure due to difficulty in positioning the cup of the prosthesis in the true acetabulum and the risk of dislocation after THA due to the low muscle tone. Methods: We herein present a case of bilateral hip pain with a history of poliomyelitis. Radiograph showed bilateral hip osteoarthritis caused by hip dysplasia due to residual poliomyelitis in right hip joint or developing dysplasia of the hip joint in left hip joint. THA was performed to bilateral hip joints. Results: Six years after bilateral THA, bilateral hip pain significantly improved. Additionally, the muscle strength on the paralyzed right side partially improved. However, the muscle strength on the non-paralyzed left side did not significantly improve. No complications related to the surgery were observed. Conclusion: Promising early results were obtained for THA in our patient with residual poliomyelitis. However, surgeons should pay attention to the potential development of complications concerning THA that may arise due to the residual poliomyelitis.

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