Hip dysplasia in the young adult caused by residual childhood and adolescent-onset dysplasia

Pun, Stephanie Y.

doi:10.1007/s12178-016-9369-0

Cited by 49 publications

(31 citation statements)

References 59 publications

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“…This anatomical aberration produces instability of the hip and increased mechanical stress at the acetabular rim. 4 In our case, mechanical stress caused by acetabular dysplasia possibly contributed to the development of coxitis, which underscores the importance of mechanical stress in the pathogenesis of PsA. In addition, coxitis was successfully treated with brodalumab, supporting the diagnosis of PsA rather than osteoarthritis.…”

Section: Magnetic Resonance Imaging (Mri) Demonstrated Bone Marrowsupporting

confidence: 55%

Mechanical stress caused by acetabular dysplasia possibly contributed to the development of coxitis in a patient with psoriatic arthritis: A case report

Watanabe

Kamata

Nagata

et al. 2020

J Cutaneous Imm & Allergy

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In the pathogenesis of psoriatic arthritis (PsA), mechanical stress is considered a central factor in the development of enthesitis. 1 However, it is not known whether mechanical stress on the hip joints contributes to coxitis in patients with PsA. We herein describe a rare case of PsA presenting with hip joint involvement possibly induced by mechanical stress caused by acetabular dysplasia.A 64-year-old Japanese man presented with scaly erythema on his scalp, lower extremities, back, and right elbow. He had been receiving treatment with topical corticosteroid and vitamin D3 for 20 years. Two years before visiting our hospital, skin lesions spread over his entire body, and he felt pain in his right hip and left ankle at the time of arising from bed and during walking.He took nonsteroidal anti-inflammatory drugs as required, which improved the pain in his left ankle but not that in his right hip. Therefore, he was referred to our hospital. Skin manifestations are shown in Figure 1A-C. Laboratory tests showed that rheumatoid factor was negative and that the serum matrix metalloproteinase-3 level was within the normal range. Serum C-reactive protein level was slightly elevated (0.17 mg/dL. Normal rage;≦0.14 mg/dL). X-ray imaging revealed erosion of the right lesser trochanter of the femur and borderline acetabular dysplasia, although the hip joint space was not narrowed ( Figure 1D). Magnetic resonance imaging (MRI) demonstrated bone marrowedema of the anterior inferior iliac spine and the lateral region of the acetabular roof ( Figure 1E). We consulted with an orthopedist, and he was diagnosed with PsA accompanied by enthesitis of the right rectus femoris muscle. Treatment with brodalumab was started, resulting in amelioration of his right hip pain in 4 weeks. Five months later, his skin manifestations disappeared completely. MRI performed 16 months after commencement of brodalumab demonstrated a decrease in the amount of bone marrow edema ( Figure 1F).Enthesitis is characteristic of spondyloarthritis including PsA, and enthesitis occurs in 23%-53% of PsA patients. 2 It was recently clarified that mechanical stress is a central factor in the development of enthesitis. 1 The Achilles tendon, plantar fascia, and lateral epicondyles are the sites most commonly affected by enthesitis, 2 while only 6.3% of PsA patients present with coxitis. 3 However, the cause of coxitis in patients with PsA has not been discussed well in the previous literature. In our case, the X-ray image revealed borderline acetabular dysplasia. Acetabular dysplasia is an unstable ball-in-socket hip joint that is characterized by a shallow acetabulum that does not cover the femoral head sufficiently. This anatomical aberration produces instability of the hip and increased mechanical stress at the acetabular rim. 4 In our case, mechanical stress caused by acetabular dysplasia possibly contributed to the development of coxitis, which underscores the importance of mechanical stress in the pathogenesis of PsA. In addition, coxitis was successfully trea...

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Section: Magnetic Resonance Imaging (Mri) Demonstrated Bone Marrowsupporting

confidence: 55%

Mechanical stress caused by acetabular dysplasia possibly contributed to the development of coxitis in a patient with psoriatic arthritis: A case report

Watanabe

Kamata

Nagata

et al. 2020

J Cutaneous Imm & Allergy

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“…This indicates that patients with more severe dysplasia may get degenerative change in their hip joints earlier and need to undergo arthroplasty surgery earlier. This agrees with a statement previously by Pun who stated that “in general, the more severe the dysplasia, the higher the risk is of developing osteoarthritis.”…”

Section: Discussionmentioning

confidence: 99%

Gender and disease severity determine proximal femoral morphology in developmental dysplasia of the hip

Boughton

Uemura

Tamura

et al. 2019

Journal Orthopaedic Research

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In this computed tomography (CT) morphological study we describe the way the proximal femoral morphology differs with worsening degrees of developmental dysplasia of the hip (DDH) and describe gender differences in patients with DDH. Forty-nine male patients with DDH were matched with 49 females with DDH, using age and the Crowe classification of DDH severity. The femoral length, anteversion, neck-shaft angle, offset, neck length, canal-calcar ratio, canal flare index, lateral center-edge angle, alpha angle, pelvic tilt, and pelvic incidence were measured for each patient on their pre-operative CT scans, prior to total hip arthroplasty surgery. Femoral anteversion and neck length were 16˚and 47 mm, 25˚and 36 mm, 26˚and 43 mm, and 44˚and 36 mm, for Crowe I and III males and Crowe I and III females, respectively. The mean male anteversion was 22˚(AE14), compared to 30˚(AE15.5) in females (p ¼ 0.02, Confidence Interval: 1.6-14.9). Gender differences in femoral length, neck length and offset lost significance when heightnormalized and no other significant gender differences were found. In conclusion, femoral neck length reduces with increasing DDH severity, whilst anteversion tends to increase. Male patients with DDH have significantly less femoral anteversion, which has important implications for osteotomy and arthroplasty surgery in DDH. ß

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“…In the long run, this development would result in shallow and narrow acetabulum, abnormal distribution of cartilage, and deformity aggravation. [15,16]…”

Section: Discussionmentioning

confidence: 99%

Analysis of acetabulum in children with developmental dysplasia of the hip by MRI scan

Zhou

Lou

et al. 2019

Medicine

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To review the value of acetabular magnetic resonance imaging (MRI) in children with developmental dysplasia of the hip (DDH) of different ages.Eighty-eight medical records of children with unilateral DDH who were diagnosed and treated in our hospital between January 2010 and December 2015 were retrospectively analyzed. The affected hips were put into the case group, and the normal hips were put into the control group. All cases were further divided into 3 age groups: infant (<1 year), 16 cases; young children (1–3 years), 48 cases; and children (3–13 years), 24 cases. The differences of the acetabular depth (AD), the bony acetabular index (BAI), and the cartilaginous acetabular index (CAI) between each group were measured and compared for a linear correlation analysis. At the same time, the distribution of the acetabular cartilage in the anterosuperior, top, and posterosuperior parts (the three parts) from the two groups was measured, respectively.Measurement results from both the case and control groups were as follows: AD was 5.46 ± 2.62 mm and 9.74 ± 2.33 mm; BAI was 33.26 ± 5.49° and 23.50 ± 5.33°; and CAI was 21.04 ± 6.16° and 12.71 ± 4.83°. Differences from the two groups were statistically significant (t = 11.94, 13.78, 9.16, P < .05); BAI and CAI were linearly correlated (r = 0.86, 0.75, P < .05). The AD in infant, young children, and children groups from the case group were 4.26 ± 0.42 mm, 4.79 ± 1.74 mm, and 7.31 ± 2.74 mm, respectively, which was statically significant as well (F = 11.37, P < .05). Under the same grouping criteria, BAI was recorded as 29.04 ± 5.11°, 34.56 ± 4.27°, and 33.12 ± 5.69°; CAI was recorded as 16.62 ± 5.50°, 21.79 ± 6.33°, and 20.91 ± 6.40° separately. There was a linear correlation (r = 0.78, 0.65, P < .05) between BAI and CAI in young children and children groups. The distribution of acetabular cartilage in the above-mentioned three parts from both young children and children groups was statistically significant (P < .05).MRI is a satisfactory imaging modality to children with DDH of different ages for the assessment of AD, BAI, CAI, and acetabular cartilage in multiple locations. It can provide ample imaging reference to clinical evaluation of the acetabulum development in DDH.

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Hip dysplasia in the young adult caused by residual childhood and adolescent-onset dysplasia

Cited by 49 publications

References 59 publications

Mechanical stress caused by acetabular dysplasia possibly contributed to the development of coxitis in a patient with psoriatic arthritis: A case report

Mechanical stress caused by acetabular dysplasia possibly contributed to the development of coxitis in a patient with psoriatic arthritis: A case report

Gender and disease severity determine proximal femoral morphology in developmental dysplasia of the hip

Analysis of acetabulum in children with developmental dysplasia of the hip by MRI scan

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