The Rheumatoid Hip

Abstract

Hip involvement in rheumatoid arthritis varies. Ten per cent of Vainio and Pulkii’s (1961) patients, 17% of Gschwend’s (1977) study group, 10%-33% of Sweetnam et al.’s (1960) and 30% of Fura et al.’s (1975) patients suffered from rheumatoid coxitis. In approx. 3% (Lenoch et al. 1966) there was monarticular involvement of the hip. As already mentioned, the inflamed synovial tissue reacts in a uniform manner. It is the extent and the intensity of the destruction that vary. Thus the clinical appearances of hip joints affected by rheumatoid arthritis differ only marginally. Conclusions can be drawn about the original form of the disease only from the time of the onset, the course, the manifestations and the destructive mechanisms. In rheumatoid arthritis, for example, hip joint involvement is rarely unilateral. An occasional exception to this is the often monarticular course of juvenile rheumatoid arthritis. In the rare cases of psoriatic arthritis with involvement of the hip, this is usually monarticular and does not feature the severe mutilation that is typical of this disease in the small finger joints. In ankylosing spondylitis, involvement of the hip joint can swiftly end in ankylosis. Phases of considerable destruction with marked osteolysis occur in juvenile ankylosing spondylitis (Fig. 10).