Early Diagnosis of Hip Joint Involvement of Ankylosing Spondylitis Using Magnetic Resonance Imaging in the Absence of Clinical and X-Ray Findings

Abstract

Objectives: This study aims to describe magnetic resonance imaging (MRI) findings of hip joint involvement in ankylosing spondylitis (AS) in the absence of clinical and X-ray signs. Patients and methods: Between January 2012 and June 2012, 23 patients with AS without hip pain symptoms who were admitted to Adana Training and Research Hospital, Department of Physical Therapy and Rheumatology were included in the study. The control group consisted of 20 healthy individuals. All patients underwent MRI examination of both hips. Results: Of 23 patients, 10 (43.4%) had a pathological finding in at least one of the two sides based on the MRI findings. Seven patients demonstrated unilateral, and three patients demonstrated asymmetrically bilateral involvements. Bone marrow edema was present in six out of the 46 hip joints (13%). Eleven hip joints (24%) showed synovial fluid. One patient had bone marrow edema together with a subchondral cyst, while another patient demonstrated a combination of bone marrow edema and tendinitis. Conclusion: There may be hip joint involvement in AS patients even in the absence of clinical and X-ray signs. Early detection of bony abnormalities may prevent both the damage to the bone and the development of ankylosis.

Cardiometabolic Risk Factors in Patients With Ankylosing Spondylitis

“…[15][16][17][18] Inflammatory rheumatic diseases trigger cardiovascular conditions, increasing mortality and morbidity. 19 The risk of atherosclerosis, in which inflammation plays a primary role, was increased in AS patients.…”

Total hip arthroplasty in fused hips with spine stiffness in ankylosing spondylitis

“…Small joints of the hand are rarely involved[ 6 ]. Early hip involvement is marked by synovitis with synovial thickening and increased synovial fluid, as evidenced) by magnetic resonance imaging even in asymptomatic hips with AS[ 8 ]. Hip involvement with inflammation and edema is accompanied by involvement of the sacroiliac joint, symphysis pubis and shoulders.…”

“…The hip joint radiographs reveal concentric osteoproliferation and acetabular erosion[ 4 ]. Synovial and capsular inflammation responsible for pain and decreased movement, with other incompletely specified mechanisms, eventually leads to hip degeneration in AS[ 4 , 8 ]. The hip disease progression seems more significant in males with younger age of onset, eventually requiring total hip arthroplasty (THA)[ 9 - 12 ].…”

Female with Ankylosing Spondylitis from the 7th–6th century BCE Lori Berd burial (Armenia)

“…In later phases, the cervical spine may be affected (Ortner 2003). In the appendicular skeleton the majority of usually affected joints include the hips and shoulders (Van der Linden and Van der Heijde 2001; Soker et al 2016;Soker et al 2014). The disease is more common in men with a 5:1 (Resnick and Niwayama 1988), and even 9:1 male/female ratio (Ortner and Putschar 1985;Aufderheide and Rodríguez-Martín 1998).…”