Cox

Cox - inflammation of the hip joint. Depending on the etymology distinguish nonspecific (acute purulent) and specific (usually tuberculosis, brucellosis rarely, syphilitic, and others.) Cox.

Acute suppurative Cox. Joint infection in this form coxitis contact can occur through hematogenous or inflammatory processes (sepsis, tonsillitis , otitis media , pneumonia , osteomyelitis, etc.). Characterized by acute onset, rapid course, expressed local changes and overall reaction to intoxication (increase in body temperature, changes in blood counts). Especially hard is acute purulent coke in gunshot wounds.

Treatment is carried out only in a hospital. It begins with immobilization and antibiotic therapy, including the use of antibiotics and sulfa drugs. In testimony resorted to hip resection (especially in Firearms Cox). After the operation carried out immobilization of a limb into functionally favorable position in order to prevent perverse joint installations.

Coxitis TB is more common in children. joint disease usually occurs secondarily from the main chamber into the lungs, the kidneys or other organs. Mycobacterium tuberculosis through the blood vessels are recorded in rich areas epimetafizarnye bones, most head and neck of femur and acetabulum in the area, where the process is usually proliferative character develops, accompanied by caseous necrosis. Necrotic changes in the synovial membrane and the articular ends of the bones leads to their destruction. As a result of the destruction of the acetabulum and the femoral head can occur dislocation with displacement. Scola in the joint cavity pus often breaks into soft tissue, forming sinter abscesses, often with fistulas.

The disease begins unnoticed. One of the first symptoms - pain, which may radiate to the knee area. The patient begins to limp, sparing the lower limb. There are low-grade fever, lymphocytosis, increased erythrocyte sedimentation rate, positive tuberculin test. The patient should be sent to the TB hospital for a special examination. X-ray examination in this period it is possible to identify the isolated pockets of tuberculosis in the acetabular or femoral head.

At the break of focus in the joint cavity pain intensifies, limited movement in the joint. Increasing muscle atrophy , especially the thigh muscles and buttocks. Muscle atrophy is accompanied by a seal subcutaneous tissue layer of the hip on the affected side - positive symptom Alexandrov. End Receiving typical position - it is bent and brought into the hip joint.

The active period of the disease in the absence of treatment lasts 1-2 years, then the inflammation subside. Pain decreased, but saved the hip joint deformity, muscle atrophy , limb shortening, pathological dislocation of the hip.

Treatment is carried out in a hospital. It includes orthopedic activities, including surgery on the testimony, and the specific anti-TB chemotherapy. In order to ensure complete rest and unloading of the hip joint for a long time applied a plaster bandage koksitnuyu. Plaster bandages changed every 2 - 3 months, at the same time produce a control x-ray. When remission and Limitation of tubercular process plaster cast is removed and the patient allowed to walk with crutches in the discharge splint, and then with a full load on the limb. Due to the fact that the plaster cast is applied to the long-term, patient requires careful maintenance. Improper retraction limb in a sling, it is too high or low position results in a pressure bandage on the edges of the soft tissue that causes rubbing and pressure sores. Daily monitoring of the correct position of the limbs is a reliable prevention of these complications.

Much attention should be paid to patient care, including wipe the skin camphor alcohol, spending perineal toilet and so on. D. Chemotherapy is the most effective anti-TB agents in early disease. In advanced osteo-articular changes its efficiency is much lower. Of great importance in treatment and have a rational mode of restorative therapy. Good nutrition, prolonged exposure to outdoor physiotherapy help activate the body's defenses and remission of tubercular process. The use of the gym, including isometric muscle tension under the plaster cast, allows, despite the long-term immobilization, prevent muscle atrophy.

Cox occurring after measles, scarlet fever and other infectious diseases, it flows relatively easily: marked pain in the joint, a violation of his function, effusion in the joint cavity. The process is relatively fast docked in the treatment of the underlying disease. The end result of it can be stiffness in the joint. Prevention is a timely and adequate treatment of the underlying disease.