Background Hip involvement is a common but little studied feature of spondyloarthritis (SpA).
Objectives The aim of the present paper is to study the prevalence, clinical and radiological features of hip involvement, and the association with criteria for severity, in a cohort of patients with SpA.
Methods Study design: retrospective single center observational study between 2010 and 2013. Patients: definite SpA (Amor's criteria).
Data collection: prevalence of hip involvement, and if present, the date of appearance, the localization and nature of the pain, treatments performed (intra-articular injections, surgery) and outcomes of total joint replacement (TJR).
Analysis: descriptive analysis.
Results 152 consecutive SpA patients were assessed: 42/152 patients (27%) suffered from SpA-associated hip involvement; median age 32.38±13.5 (range 14–74) years, median symptom duration 8.24±6.3 years, 33 (78.6%) were men. None patient with hip involvement had been treated by anti TNF at data collection. Hip involvement appeared during the first 3 years of disease duration in 78%.
The median Lequesne score of the hip was 17.3±3.59 [11-22].
The BASDAI was at 5.47±1.93 and the BASRI was at 6.5±3 [2-6].
Prevalence varied according to SpA predominant manifestation: more frequent in axial patients (32 patients, 76.6%), than in peripheral disease.
The features of hip involvement were pseudoarthrosic in 61.9% (26 patients), destructrive or pseudorhumatoid in 10 patients (23.8%), contrictive in 5 cases (11.9%) and synostosant in 1 patient (2.4%).
Hip involvement was bilateral in 50% (21/42). 23 patients (54.8%) received intra articular corticoid injections (of which, 4.8% were triamcinolone hexacetonide, and acide osmique in the other cases).
16 patients (38.1%) have one synoviorthesis, 6 (14.3%) have two and one patient had underwent three synoviorthesis.
In all, 6 patients (6% of the whole group and 14.3% of patients with hip involvement) had a TJR. TJR was unilateral in 5 patients and bilateral in one case.
The median delay between first hip symptoms and TJR was 47 months (range 0–29 years).
After a median follow-up of TJR of 101 months (range 2– 27 years), TJR was considered as having a immediate good function in 100% and only 16% (1/6) patients had TJR complications with a second TJR of the hip.
Conclusions Hip involvement is a frequent manifestation in SpA (X %), often bilateral, and associated with non-Caucasian origin. One third of the patients needed total joint replacement. Physicians should be wary of hip pain in SpA patients and implement rapid diagnostic procedures in such cases.
Burki V1, Gossec L, Payet J, Durnez A, Elhai M, Fabreguet I and al. Prevalence and characteristics of hip involvement in spondyloarthritis: a single-centre observational study of 275 patients. Clin Exp Rheumatol. 2012;30:481-6.
Disclosure of Interest None declared