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Destructive arthritis of the hip in a patient with Crohn's disease
A C Tibbles1, D R Mierau, J Sibley
1Canadian Memorial Chiropractice College, Toronto.
Insights
Crohn's disease can cause rare joint problems. This case highlights destructive hip arthritis as a complication, emphasizing the need for consideration in patients with persistent joint pain.
Area of Science:
- Rheumatology
- Gastroenterology
- Radiology
Background:
- Crohn's disease is a chronic inflammatory condition.
- Peripheral arthropathy is an uncommon complication of Crohn's disease.
- This case focuses on isolated destructive peripheral arthropathy.
Observation:
- A 28-year-old male with a history of Crohn's disease presented with chronic left hip pain.
- Initial radiographs were normal, but follow-up imaging revealed destructive hip changes.
- The patient's gastrointestinal symptoms had resolved previously.
Findings:
- The diagnosis was destructive arthritis of the left hip secondary to Crohn's disease.
- Treatment involved observation and nonsteroidal anti-inflammatory drugs.
- Radiographic evidence showed progressive joint destruction over two years.
Implications:
- Destructive arthritis should be considered in young adults with Crohn's disease and persistent joint pain.
- Early recognition and diagnosis are crucial for managing this rare complication.
- This case underscores the importance of correlating clinical presentation with imaging findings in Crohn's disease patients.
Objective:
Isolated destructive peripheral arthropathy is a rare complication of Crohn's disease. We describe the clinical course and radiographic findings of such a case.
Clinical Features:
A 28-yr-old male presented to our chiropractic clinic with chronic left hip pain. The patient was known to have Crohn's disease. Five years earlier the gastrointestinal symptoms resolved with a brief course of prednisone. However, the left hip pain continued. A radiograph of the left hip was read as normal. Repeat radiograph, 2 yr later, revealed destructive changes of the left hip and, in retrospect, early destructive changes could be seen on the initial radiograph.
Intervention And Outcome:
The diagnosis, in this case, was destructive arthritis of the left hip secondary to Crohn's disease. The treatment selected in this case was observation and nonsteroidal anti-inflammatory drug use.
Conclusion:
This diagnosis, a relatively rare complication of Crohn's disease, should be considered in a young adult patient with Crohn's disease and persistent peripheral joint pain.