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inflammation of the hip joint. There are two kinds of coxitis: tuberculous and nontuberculous.
Tuberculous coxitis usually develops in children aged five to ten when they are in a weakened condition (owing to infection, unfavorable living conditions) after entry of the causative agent of tuberculosis from a primary focus (usually from the lungs). An injury is often a predisposing factor. The disease sets in gradually with symptoms of systemic tuberculous intoxication. Then lameness and pain in the knee occur and gradually spread to the hip joint. As the process in the joint develops, mobility becomes limited and contractures of the muscles follow. The limb becomes fixed in a position of adduction and rotation inward, and its muscles atrophy. The limb shortens as a result of injury to the growth zone of the joint and destruction of the joint ends. The pelvis on the affected side becomes slightly raised and tilted forward. Curvature of the spine (scoliosis) develops and forward flexure in the lumbar spine (lordosis) intensifies. The joint capsule becomes filled with pus. The pus descends through the intermuscular crevices, forming wandering abscesses on the hip or, less commonly, in the gluteal region. Pathological dislocations occur if there is extensive destruction of the head of the femur and acetabulum. Treatment is supporting and antituberculotic. Orthopedic measures (plaster casts, traction, wearing a splint) help the process to subside. These measures are also aimed at preventing or correcting deformity of the limb. If conservative treatment is ineffectual, surgery (arthrodesis, osteotomy, and in some cases arthroplasty) is used to immobilize the joint or straighten the limb. Health resort therapy in Evpatoriia, Gelendzhik, and Anapa is beneficial.
Nontuberculous coxitis results when the joint becomes infected from the surrounding tissues when there are purulent diseases, open injuries to the joint, or systemic infectious diseases. The onset is acute; the disease develops rapidly with high (septic) temperature and sharp pains. Treatment consists of rest (plaster cast, traction) and the administration of antibiotics. Subsequent treatment consists of surgery: incision into the joint or its partial excision.
M. A. KON