May 11, 2016 - 11:22 AM
At 92, this is my initial suspicion although the MRI will give much more details and likely will point to a diagnosis. Additional lab tests may be needed.
Regarding treatment, depending on patient's overall medical condition, ability to tolerate surgery etc, the patient may be a candidate for a hip replacement. Medications such as non-steroidal anti-inflammatory drugs may help often combined with pain management and physical therapy if the patient is not a surgical candidate. An orthopedic surgeon should easily assist with making these determinations.
May 11, 2016 - 01:18 PM
Decreased cartilage between the ball and socket of a hip joint without a fracture is typically osteoarthritis, which is wear and tear of a joint to the point that it breaks down the joint and the underlying bone. This causes a lot of pain and stiffness, which often times causes limited movement. Depending on the patient's level of hip deterioration, cognitive level, activity level and health status, an orthopedic surgeon will determine if she is a candidate for a hip replacement. Often times, they recommend physical and occupational therapy, with pain medications to help control the pain, which will ultimately increase movement.
Cortizone injections are sometimes given to help with immediate pain control if it is intense and appropriate for the patient. They usually work like magic or not very well.
Physical therapy can help with pain control and exercises to help stabilize the hip and make getting around safer. They recommend devices such as a cane or a walker if it will decrease hip pain and increase safety during walking, as a painful hip affects balance and the way you walk and increases risk of falls.
Occpational therapy can help with making sure she can do all the things she needs to do safely with hip pain such as getting dressed or bathing. They can also teach energy conservation and joint protection techniques if she needs to "live with the bad hip."
May 12, 2016 - 07:44 AM
Your loved one most likely has advanced degenerate arthritis of the hip, a condition typically caused by decreased cartilage between the ball and socket in the hip. This cartilage, undamaged, allows the bone to glide inside the socket of the hip. When the cartilage is damaged or has decreased as it often does with age, bone rubs against bone causing pain, swelling and limitations to movement.
Start with the MRI. Then you should have a thoughtful discussion about the findings, the goals of any treatment, and the options with your physician or an orthopedist. Sometimes conservative treatment with physical therapy, pain management and other modalities are adequate. Sometimes surgery is needed. It really depends on how the person is doing functionally, what their tolerance for procedures is, and how much pain they are dealing with today.
Hope that helps and best of luck!