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Abstract: Mr. Qin suddenly felt pain, swelling and limitation of movement in the hip joint during exercise, so he came to the clinic and was diagnosed with hip synovitis with hip effusion by hip MRI. After comprehensive conservative treatment, the patient’s hip joint discomfort disappeared and function gradually recovered, and he did not experience hip joint pain and limitation of movement when jogging or swimming.
Basic information】Male, 45 years old
Disease Type】Hip synovitis with hip joint effusion
Hospital】Harbin First Hospital
Date of consultation】June 2021
Treatment plan】Comprehensive conservative treatment (continuous bed rest + ultrashort wave therapy + muscle strength training)
Treatment period】7 days of inpatient treatment, 1 month of outpatient review
Treatment effect] Hip discomfort disappeared, no hip pain or limitation of movement when jogging or swimming
I. Initial consultation
The patient, Mr. Qin, suddenly felt hip joint pain during exercise, accompanied by swelling and limitation of movement, and the pain symptoms were significant when walking under normal weight. As the patient’s condition was not serious, comprehensive conservative treatment could be considered to relieve clinical symptoms and promote the remission of synovial inflammation, and if the hip synovial inflammation recurred and continued to worsen, hip arthroscopy could be further considered to remove the inflammatory synovium.
II. Treatment process
After the occurrence of hip synovitis, the patient’s hip joint pain and activity limitation were obvious. In order to restore the function of the hip joint, comprehensive conservative treatment was chosen after communication with the patient. In the acute stage, the patient was kept at bed rest and avoided weight-bearing activities of the hip joint, and the pain and swelling of the hip joint were controlled in about 3 days, and then ultrashort wave therapy was started to promote the reduction of synovial inflammation, improve the blood circulation of the synovial membrane of the hip joint, and promote the absorption of joint effusion. At the same time, muscle strength training around the hip joint, such as straight leg raising training, was carried out to enhance the stability of the hip joint, promote the inflammation and effusion to subside, and gradually restore the normal weight-bearing activities of the hip joint.
III. Treatment effect
After comprehensive conservative treatment, the patient’s clinical symptoms such as joint swelling, pain and restricted activity were significantly improved, and he was able to gradually leave the bed and walk freely without the need for an assistive walker or double crutches, and was discharged after 7 days of hospitalization. After physical examination, it was confirmed that the hip synovitis was completely cured.
IV. Notes
We are glad that the patient’s pain was relieved and the hip joint activity was restored after treatment. Patients should pay attention to keep the normal weight-bearing of the hip joint after discharge from the hospital, avoid participating in strenuous sports, and fully move the hip joint before exercising to strengthen the blood circulation of the hip joint and prevent the synovial membrane from being squeezed by hard tissues such as femoral head and acetabulum due to sudden activities, which may induce hip synovitis. Pay attention to keeping the hip joint warm in daily life. If there is sudden pain in the hip joint, restricted movement and fear of walking with weight, you need to go to the orthopedic clinic in time for follow-up to confirm whether hip synovitis has recurred. If hip synovitis occurs repeatedly, it is easy to produce inflammatory synovial fluid, which can destroy joint cartilage and cause serious damage to the function of the hip joint, so it is necessary to pay great attention to it.
V. Personal insight
The occurrence of hip synovitis in this patient is mainly related to sports trauma. It is recommended to actively warm up before sports and pay attention to avoid direct impact on the hip joint or hip sprain during sports, which can prevent the reappearance of hip synovitis. Patients should strengthen the training of muscle strength around the hip joint in the future to improve the stability of the hip joint, and need to adhere to it for a long time in order to achieve a better prevention effect.