SAT0256 Prevalence and Characteristics of Hip Involvement in Spondyloarthritis
Authors: M. Jguirim, A. Mhenni, W. Mnari, L. Mani, S. Zrour, M. Younes, I. Béjia, M. Touzi, N. Bergaoui
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Hip involvement is a common but little studied feature of spondyloarthritis (SpA). <h3>Objectives</h3> 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. <h3>Methods</h3> <i>Study design:</i> retrospective single center observational study between 2010 and 2013. <i>Patients:</i> definite SpA (Amor9s criteria). <i>Data collection:</i> 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). <i>Analysis:</i> descriptive analysis. <h3>Results</h3> 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. <h3>Conclusions</h3> 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. <h3>References</h3> 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. <h3>Disclosure of Interest</h3> None declared