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Hip involvement frequently associated with spondylarthritis
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Hip involvement, often bilateral, was a frequent manifestation in patients with spondylarthritis and also was associated with ethnicity, according to study results.
Researchers in Paris assessed 275 patients with spondylarthritis (SpA) (median age, 45 years; 61% men) and median symptom duration of 14 years in a retrospective observational study. Hip involvement was confirmed radiographically as pain related to SpA inflammation. Demographic data and SpA characteristics and treatments performed for hip involvement also were collected. Kaplan-Meyer analysis was used to estimate hip involvement prevalence. Patients with and without hip involvement were compared by using multivariate Cox analysis.
Eighty-eight percent of patients were of Caucasian origin and 7% were of North African origin. Seventy-nine percent tested positive for the human leukocyte antigen B27. Eighteen percent had hip involvement, with prevalence rates of 13.4% (95% CI, 9.1-17.6), 16.9% (95% CI, 11.8-22.0) and 25.5% (95% CI, 17.7-33.3) after 5, 10 and 20 years, respectively, of disease duration. Eighteen patients (36.7% of all patients with hip involvement) already had hip involvement at SpA diagnosis, and 61% reported bilateral involvement. Forty percent of North Africans had hip involvement compared with 16% of Caucasians (P=.014). There was a younger median age at SpA diagnosis for patients (mean age, 24 years) with hip involvement. Sixteen patients with hip involvement (33%) required surgery to replace 23 joints.
“Physicians should be wary of hip pain in SpA patients and implement rapid diagnostic procedures in such cases,” the researchers concluded. “Future studies will show us if its prevalence decreases with increasing access to biologics.”
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