AB0720 HIP INVOLVEMENT IN A COHORT OF EGYPTIAN JUVENILE IDIOPATHIC ARTHRITIS PATIENTS
Authors: A. Radwan, H. Alzahrani, Y. Alzahrani, A. Elsaman
Journal: Annals of the Rheumatic Diseases (2021)

Background: The hip joint is frequently involved in Juvenile Idiopathic Arthritis (JIA). It is more common with polyarticular, systemic and enthesitis-related forms and with severe uncontrolled disease. Chronic hip arthritis leads to irreversible joint damage with marked impairment of quality of life and functional limitation [1]. Unilateral or bilateral hip arthritis occurs in 30- 50% of children with JIA [2]. Objectives: The aim of this study is to assess the pattern of hip involvement in a cohort of Egyptian JIA patients in terms of epidemiological aspects, JIA pattern, bilateralism, associated extra-articular manifestations, radiological features, treatment and prognosis. Methods: We included 179 patients who fulfilled the International league against rheumatism criteria for JIA. Epidemiological, clinical, radiological, and therapeutic parameters were assembled and analyzed. Hip involvement was assessed using a semi-quantitative score of pain and tenderness for the hip, CARSH radiographic score of the hip, and Harris functional hip score. JADAS-27 was used for assessment of disease activity. Results: We included 113 girls and 66 boys; with a female: male ratio of nearly 2:1. The age at onset mean was 8.8±3 years (8.9±2.9 for females and 8.6±3.1 for males). The mean age at the study time was 13.3±4.1 years. The disease duration mean was 4.5±2.9 years. Clinically; 20.1% of the cases had hip involvement (12.8% unilateral and 7.3% bilateral), while by imaging, around 30.7% of the cases have hip involvement (19.6% unilateral and 11.2% bilateral). The mean age for cases with hip involvement was 14.1±4.3, compared to 12.9±4 among those with no hip involvement. The mean disease duration for those with hip arthritis (either clinical or by imaging) was 5.5±2.9 years, compared to 4.1±2.9 among those with no hip involvement (Figure 1). Figure 1. Difference between JIA cases with and without hip involvement. The Mean JADAS-27 was 13.5±6.2 and for those with hip involvement was 16.3±6.3. The commonest pattern of JIA with hip arthritis was polyarticular followed by enthesitis-related arthritis. There was a strong significant correlation between JADAS-27 and hip involvement at one hand and Harris score, semi-quantitative score for pain and tenderness at the other hand. Further, disease duration was significantly correlated with hip involvement as well. Among cases with hip involvement, 25% demonstrated destructive changes and 30% showed growth abnormalities. Conclusion: Hip arthritis in JIA is related to polyarticular and enthesitis-related pattern. Longer disease duration, seropositive polyarticular pattern were related to poor prognosis for hip arthritis. References: [1]Singh JA, Cleveland JD. Juvenile idiopathic arthritis is associated with higher healthcare utilization after total knee or hip replacement. Scandinavian journal of rheumatology 2021; 50: 34-9. [2]Rostom S, Amine B, Bensabbah R, Abouqal R, Hajjaj-Hassouni N. Hip involvement in juvenile idiopathic arthritis. Clinical rheumatology 2008; 27: 791-4. Disclosure of Interests: None declared