Background According to the carried out epidemiological studies in Russia of patients with ankylosing spondylitis (AS) defeat of the hip joints was impairment in 46% of cases, but was the reason for the replacement in 7% of cases. i
Objectives To compare the clinical manifestations of hip arthritis (coxitis) with the results of magnetic resonance imaging (MRI) of the hip joints (HJ) in patients with ankylosing spondylitis (AS).
Methods Examined 117 patients (mean age 31,7±12.7 y meeting modified N-Y criteria), with complaints of pain in the hip joints. The average age of onset of disease was 26.3±20.3 years, HLA-B27 identified in 93% of patients. The median duration of AS – 57 [2–384] months. BASDAI 5,7±3,1. Diagnosis of hip septic arthritis were made based on clinical signs - the presence of pain in hips and/or restriction of movements in HJ at the time of patient admission to the clinic. In addition to clinical and radiographic examination all patients were performed MRI modes T1 and STIR.
Results: The Median duration of clinical manifestations of coxitis by the time of the study was 60 months. [25‰; 75‰], evaluation of pain in HJ for numeric rating scaler (NRS) – 4 [2; 8]. According to MRI identified the following inflammatory changes (IC): synovitis-71 (83%) patients, bone marrow edema (BME)- 44 (31,6%) patients (BME acetabulum 36%, BME heads 63%), a combination of synovitis and BME were 7 patients (9%). Depending on radiological stage (estimated by BASRI hip), patients were divided into two groups (table 1).
Conclusions MRI allows to clarify the cause of the pain and limitations of movement in HJ with AS, determine the patient has inflammatory changes, including in the absence of radiographic changes in these joints. Patients with severe radiological change (BASRI II-IV), have a greater duration of the disease, severe functional abnormalities in the BASFI index. With increasing radiological stage (BASRI hip II-IV) increased the detection rate of osteitis by MRI. Further research to clarify the relationship of clinical manifestations of coxitis (pain level) from MRI data.
Disclosure of Interest None declared