Anatomy 結構
Hip is a very stable joint, ball and socket. The femur (the thigh bone) has a perfect sphere head, which articulates with the acetabulum (the hip socket). The joint is further deepened for additional stability with a rim of fibrous tissue called labrum.
The perfect sphere of femoral head can be affected by developmental problem in childhood (Development Dysplasia of Hip, DDH), deformity of the growth plate range of motion (Slipped Capital Femoral Epiphysis, SCFE), AVascular Necrosis (AVN), trauma and degeneration.
For whatsoever the reason, once the perfect sphericity of femoral head is disrupted, degeneration is an inevitable outcome.
髖關節是一個非常穩定的關節，就像一個球放在杯入面一樣。股骨（大腿骨）有一個完美的球形頭，與髖臼（盤骨）相連。關節外圍有一環形纖維組織，關節唇（裙邊），它進一步令髖臼深處加深，從以獲得更佳的穩定性。
股骨頭的完美球體可能在以下情況受影響，例如在兒童時期出現的發育不全問題（髖關節發育異常，DDH），股骨頭骨骺滑脫症（SCFE），缺血性壞死（AVN），創傷和退化等。
無論是出於什麼原因，一旦股骨頭的完美球形不再，退化就再難避免。
Pathology 毛病
Disease 病變
The followings are common pathologies in hip
以下是常見髖關節病變
- Osteoarthritis
- Avascular Necrosis of hip
- Hip labrum tear
- Trochanteric bursiitis
- Femoral neck fracture
- Developmental dysplasia of hip
- Slipped capital femoral epiphysis
- 退化性關節炎
- 髖關節缺血性壞死
- 髖關節唇裂
- 股骨轉子滑囊炎
- 股骨頸骨折
- 關節發育異常
- 股骨頭骨骺滑脫症
Investigation 評估
MRI is required to review soft tissue status. X-ray would be needed for bony pathology.
磁力共震片能夠提供軟組織情況。骨頭問題，例如骨折，就會需要照X光。
Management 治療
Conservative treatments are indicated for majority of cases. They included,
- Physiotherapy
- Chiropractor
- TCM practitioner
- Prescribed Exercise
- Medication
For cases failed conservative treatments, or when the injury is unstable, then surgical intervention would be indicated.
For patients with witnessed deterioration, surgical intervention might be advocated.
絕大多數病人只需採取保守治療。他們包括
- 物理治療
- 脊醫
- 中醫
- 處方運動
- 藥物（口服及外敷）
對於保守治療無效的病例，或受傷位置不穩定，醫生會改為介入治療，例如打針甚至手術。
對於持續惡化的患者，醫生往往會建議手術，以保肢體功能。
Reference
- 香港骨科醫學會資料http://hkoa.org/page13/page3/