LOOSE BODIES (HIP)
Loose bodies are small loose fragments of cartilage or bone that float around within the joint. Loose bodies can occur if there has been bleeding within the joint, death of tissues lining the joints associated with tuberculosis, osteoarthritis, and rheumatoid arthritis. Other causes include fractures, trauma, bone and cartilage inflammation, and benign tumours of the synovial membrane (such as synovial chondromatosis), as well as a condition known as osteochondritis dessicans. They can cause pain, swelling, locking and catching of the joint.
X-rays help with the diagnosis of loose bodies, though small loose bodies that contain little or no bone may not be visible on plain X-ray. In these circumstances, CT scans, ultrasound, or MRI scans may be needed to determine the presence and number of the loose bodies.
Small loose bodies may initially be managed with simple anti-inflammatory medications to relieve the pain and swelling. Those not settling with simple measures, may require surgical removal. This is performed by a hip arthroscopy, or rarely open surgery (arthrotomy).
Larger loose bodies resulting from fractures, fragments that have detached as in osteochondritis dessicans (often a large solitary osteocartilagenous fragment) may be reduced and fixed in position using screws or pins.
Synovial chondromatosis (also called synovial osteochondromatosis) is a rare, benign (noncancerous) condition that involves the synovium, which is the thin layer of tissue that lines capsule of the joint. Synovial chondromatosis can arise in any joint in the body (most commonly occurring in the knee). Although the condition is not cancerous, it can severely damage the affected joint and, eventually, lead to osteoarthritis. Early treatment is important to help relieve painful symptoms and prevent further damage to the joint. This condition typically requires partial or full removal of the synovium (synovectomy), which may be undertaken as an arthroscopic or open procedure.
Following any surgical procedure noted, a rehabilitation programme may be advised to control pain and restore function and strength in the hip.