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Radiographic hip involvement in ankylosing spondylitis: factors associated with severe hip diseases
Jinzhu Zhao1, Wei Zheng1, Chao Zhang1
1From the Department of Orthopedics, Changhai Hospital, Second Military Medical University, Shanghai; Department of Orthopedics, No. 401 Hospital, Jinan Military Region of PLA, Qingdao City, Shandong Province; Department of Orthopedics, Tianjin Medical University General Hospital, Tianjin, China.J. Zhao, MD, Department of Orthopedics, No. 401 Hospital; W. Zheng, MD; J. Li, MD; D. Liu, MD; W. Xu, MD, Department of Orthopedics, Changhai Hospital, Second Military Medical University; C. Zhang, MD, Department of Orthopedics, Tianjin Medical University General Hospital.
Insights
Severe hip disease in ankylosing spondylitis (AS) is linked to bilateral hip involvement, sacroiliitis, delayed diagnosis, early onset, and spinal issues. Hip disease severity impacts functional status in AS patients.
Area of Science:
- Rheumatology
- Orthopedics
- Radiology
Background:
- Ankylosing spondylitis (AS) frequently affects the hips, leading to significant disability.
- Understanding factors contributing to severe hip involvement is crucial for patient management.
Purpose of the Study:
- To identify demographic, clinical, radiographic, and laboratory factors associated with severe hip disease in ankylosing spondylitis patients.
Main Methods:
- A retrospective cross-sectional study involving 256 AS patients.
- Patients were categorized by the Bath Ankylosing Spondylitis Radiology Hip Index (BASRI-hip).
- Ordinal regression analysis was used to determine associations with severe hip disease.
Main Results:
- Bilateral hip involvement, sacroiliitis, delayed diagnosis, earlier age at onset, and spinal involvement were significantly associated with higher BASRI-hip scores.
- Patients with severe hip disease showed lower C-reactive protein and erythrocyte sedimentation rate levels.
- Functional status, assessed by BASFI and Harris Hip Score, differed significantly across hip disease severity groups.
Conclusions:
- Severe hip disease in AS is associated with bilateral hip and sacroiliac joint involvement, delayed diagnosis, early onset, and spinal disease.
- The degree of hip involvement directly correlates with functional status in patients with ankylosing spondylitis.
Objective:
To determine the factors associated with severe radiographic hip involvement in patients with ankylosing spondylitis (AS).
Methods:
A cross-sectional retrospective study was performed. The patients were classified into 3 groups based on the Bath Ankylosing Spondylitis Radiology Hip Index (BASRI-hip): minimal hip disease, moderate hip disease, and severe hip disease. Demographic, clinical, radiographic, and laboratory data were collected and analyzed. To identify factors associated with severe hip disease, ordinal regression analyses were performed.
Results:
A total of 256 patients were involved in the study. There were differences in the age at onset, delay in diagnosis, bilateral hip involvement, sacroiliitis, Schober's index, and occiput-to-wall distance among the 3 groups (p < 0.05). The patients with severe hip disease had lower C-reactive protein and erythrocyte sedimentation rate levels than did the minimal group (p < 0.05). The functional status based on the Bath Ankylosing Spondylitis Functional Index and the Harris Hip Score showed significant differences (p < 0.05). The results of the ordinal regression analyses showed that bilateral hip involvement, sacroiliitis, delay in diagnosis, age at onset, and spinal involvement were associated with a higher BASRI-hip (p < 0.05).
Conclusion:
Bilateral hip involvement, severe sacroiliitis, longer delay in diagnosis, early disease onset, and spinal involvement are associated with severe hip disease in patients with AS. The severity of hip involvement is associated with the functional status in AS.
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