Background Previous studies showed that the impairment of hip joints (HJ) - coxitis leads to a hip replacement and it is a frequent cause of early disability in patients (pts) with spondyloarthritis (SpA). Early detection of coxitis have a great clinical importance.
Objectives To study the incidence and character of the impairment of HJ involvement in patients with early axial SpA (axSpA).
Methods The study include 65 patients with axSpA (ASAS 2009) with disease duration <5 years and age at onset <45 years, mean age 28,5 (5,8) y., 32 (49,2%) males, 60 (92,2%) pts were HLAB27-positive, average disease duration was 24,1 (15,4) mo. The following evaluations were made: HJ pain (numerical rating scale – NRS - from 0 to 10), inter-malleolar distance (IMD), radiological HJ changes (BASRI-hip), ultrasound examination (US) and pts who had US evidence or/and clinical coxitis - MRI of hip joints. For 2 years pts taking NSAIDs at therapeutic doses. The dosages of NSAIDs accounted by the ASAS NSAID index.
Results After 2 years follow-up reduce HJ functional limitations and pain in the left HJ (Table 1). There were no statistical differences between MRI symptoms of the impairment HJ and US symptoms of coxitis at baseline and after 2 years (Table 2).
Radiographic progression (BASRI-hip≥1 stage) after 2 years follow-up founded in 7 (31,8%) pts with MRI symptoms of the impairment HJ. There are radiographic progression from normal HJ to bilateral stage 1 in 5 (71,4%) pts, from bilateral stage 1 to bilateral stage 2 in 2 (28,6%) pts. Mean NSAID index in pts with radiographic progression (31,8%) amount 62,2%, while in pts without radiographic progression – 72,5% (p=0,2).
Conclusions 1. In patients with early axial spondyloarthritis in two years of observation radiographic progression observed in 31,7% patients despite on regular intake of NSAIDs. 2. Further studies of the impairment HJ are required in patients with axial SpA.
Disclosure of Interest None declared