Wear and tear from daily movement can impact your joints with age. Many people over age 50 will experience osteoarthritis, resulting from the damage such long-term wear and tear does to the cartilage (protective tissue) between the bones of your joint.
Rapid destructive hip osteoarthritis (RDHO) is a rare type of hip joint disease that can lead to deterioration of the hip joint within months. People with this kind of osteoarthritis often requires total hip replacement (THR). The causes and risk factors for RDHO are not yet well known, and research is ongoing for this condition.
We’ll overview what we know so far about how rapid destructive hip arthritis occurs, what symptoms it presents, and the treatment options currently available.
Osteoarthritis happens as the cartilage in some joints wears down over time. What factors lead osteoarthritis to develop into rapid destructive hip arthritis isn’t fully understood. However, it seems to be most common in older women who also have osteoarthritis.
Once RDHO onsets, the condition progresses rapidly and can become debilitating.
RDHO is a very rare form of osteoarthritis. Research into possible medication triggers is ongoing, and NSAIDS and corticosteroids are considered safe for the vast majority of people. Talk with your doctor if you are worried about your risk of joint complications regarding a medication regimen.
Rapid destructive hip arthritis usually causes a sudden onset of pain that’s both severe and debilitating. RDHO can lead to complete destruction of the hip joint in as little as
Common symptoms of this joint condition include:
- hip pain
- joint stiffness or loss of movement
- inability to walk comfortably or at all
- geodes, or fluid-filled lesions, surrounded by bone in the upper part of the long leg bone (femur)
- joint space narrowing (with disease progression, the spacing normally present between joints narrows)
Because symptoms for rapid destructive hip osteoarthritis overlap with other causes of hip pain, diagnosis can take time and several doctor’s visits. The condition is believed to be very underdiagnosed.
In a series of
In evaluating, diagnosing, and treating RDHO, repeated imaging is recommended. It may take weeks or months for the changes to your hip joint to become visible.
Timely diagnosis is important for the best treatment outcome. If surgery is required, it should ideally be completed before the hip bone has completely degenerated.
Some things your doctor may do to diagnose RDHO include:
- ask about hip pain with no obvious cause that lasts from
1 to 6 months
- order scans to look for any signs of rapid bone loss on parts of the hip including the end of the femur or femoral head
- rule out other causes of hip joint pain including autoimmune disease, infection, or other inflammation
The difference between RDHO and primary hip osteoarthritis (POH) is the speed and severity of disease progression.
There are other hip conditions that can create hip pain and mobility issues, including general osteoarthritis in the hip.
Doctors will work to rule out other potential diagnoses, including:
- trochanteric bursitis
- torn labrum
- IT band syndrome
- hip fracture
- rheumatoid arthritis
- septic arthritis (resulting from an infection)
Evaluating these potential causes of hip pain will likely include performing a physical exam, requesting your symptom history, and ordering imaging tests such as an MRI or X-ray.
Rapid destructive hip osteoarthritis can onset suddenly and worsen quickly. For this reason, prompt evaluation is essential for the most effective symptom relief and best treatment outcome. If you’re experiencing hip pain, especially chronic hip pain that impacts your quality of life, seek a professional opinion.
After ruling out obvious causes of hip pain like a fracture, your doctor will review the use conservative treatment options including physical therapy and pain medications.
If RDHO is suspected or identified, and if the previous methods don’t help or worsen your condition, your doctor will likely discuss surgical options.
The most common treatment used for RDHO is a total hip replacement (THR) procedure. THR is a frequently performed surgery that is considered very safe, done over 450,000 times in the United States each year, according to the American Academy of Orthopaedic Surgeons.
This type of surgery is recommended in people with osteoarthritis when hip pain causes chronic pain, mobility problems, or disability. Possible signs you may require THR is hip pain that prevents you from walking comfortably or at all, and trouble lifting or bending your leg in general. Visible signs of joint spacing, bone spurs, and damage on the femoral head on imaging tests may be signs surgery is necessary to save the joint.
Not all people with RDHO will be good candidates for hip joint surgery. Your fitness as a surgery candidate will depend on multiple individual health factors, including your age and other chronic conditions you may have. Your doctor or surgeon will conduct a thorough assessment.
Rapid destructive hip osteoarthritis (RDHO) is a very rare disease that can onset suddenly, and quickly lead to the total breakdown of a hip joint. What exactly causes RDHO is still being studied, but total hip replacement has been shown to be the most effective treatment option.
Let your doctor know right away if you have sudden and rapidly worsening hip joint pain. It is important to rule out other causes of hip pain through a physical exam, review of symptom history, and imaging tests. Conservative treatments like physical therapy and pain medication are usually first-line options for suspected RDHO.
Early intervention is key to successfully managing this serious condition. While surgery may help reduce hip pain and improve quality of life, it may not restore full joint strength and mobility. Some people who get a THR will still need to adjust their lifestyle, in particular avoiding high impact activities.