Can total hip replacement surgery be delayed in my case?

Hello,

Welcome to icliniq.com.

I have gone through your history and the files attached here (attachment removed to protect patient identity). X-ray images are of poor quality and cannot be visualized. However, the hip joint can be observed, which is the site of pathology in your case. As per the X-ray report, you have avascular necrosis of the hip, the treatment for which is a total hip replacement. The hip replacement can be delayed until the point where the pain is bearable. You need to mention your occupation, the weight you usually lift, any exercises you do, any walking aid, the duration of medication mentioned in the query, and the distance you can travel. Your blood reports do not have any tests related to rheumatoid arthritis; then why do you seek treatment for rheumatoid arthritis? Kindly follow up with answers to these questions for further discussion.

Regards.

Hello,

Welcome back to icliniq.com.

Coming to your questions, X-ray images are not proper. The problem lies in taking the image of the X-ray film with the camera. Pathology cannot be judged adequately. From the hip X-ray, joint space reduction and a deformed femoral head can be seen. I cannot comment on the fracture as the X-ray image is unclear. Spine X-ray, nothing can be made from the image attached here. Secondly, sciatica is a clinical diagnosis after examination, and the treatment depends upon the findings of the neurological examination and MRI. With arthritic changes at the hip, pain from the hip may mimic as if arising from the spine or sciatica and hence neurological examination is a must. Lastly, THR (total hip replacement) can be delayed till you can bear the pain, as long as it is not affecting your daily living activities and spinal issues are not caused by abnormal gait due to the arthritic hip. You do have rheumatoid arthritis as per the anti-CCP report and should continue with Imitrex (Methotrexate) as prescribed by your doctor. THR is recommended at this stage from the pelvis's X-ray image. For any further doubts, feel free to discuss further.

Thank you.