Rapidly destructive hip disease: clinical and imaging abnormalities

The clinical and radiographic records of 23 patients (15 women, eight men) with rapidly destructive hip disease (RDHD) were retrospectively reviewed. Criteria for RDHD included a history of hip pain of 1-6 months duration and the radiographic appearance of a rapidly progressive atrophic form of bone destruction involving both the femoral head and the acetabulum. Radiographs of the remainder of the appendicular skeleton were assessed in 14 patients. The mean patient age was 72 years. The average time from clinical presentation to the appearance of severe hip destruction was 14 months. Five patients demonstrated similar atrophic bone destruction around other articulations. No patients had clinical or laboratory evidence of sepsis or neurologic disease. Although previous reports have suggested that RDHD is degenerative in nature, similar involvement of other articulations suggests that it may represent a focal finding of a more generalized process.