Dwosh I L, Resnick D, Becker M A
Arthritis Rheum. 1976 Jul-Aug;19(4):683-92. doi: 10.1002/1529-0131(197607/08)19:4<683::aid-art1780190405>3.0.co;2-8.
Hip involvement in ankylosing spondylitis (AS) is a common and disabling problem. The clinical and x-ray records of 87 patients with definite AS (Rome criteria) were examined to define and characterize their hip disease. Clinical hip disease was present in 33 cases (38%), was usually bilateral (91%), and tended to begin early in the disease course; it was the cause of 50% of the Class III and IV disability in the entire study group. Typical findings included regional pain, limitation of motion, muscle atrophy, and flexion contractures. Radiologic hip abnormalities occurred in 42 cases (48%). The radiographic pattern was distinctive when compared to that in two control groups and included axial migration of the femoral head (63%), concentric joint space narrowing (50%), rufflike femoral osteophytosis (36%), and protrusio acetabuli (30%). Eight patients required bilateral hip surgery. Para-articular ossification occurred in 8 of 16 replaced hips; in 5 of 8 hips it caused clinical immobility. This potentially serious complication may limit the usefulness of hip arthroplasty in some AS patients.
强直性脊柱炎（AS）累及髋关节是一个常见且导致残疾的问题。对87例符合明确AS（罗马标准）患者的临床和X线记录进行检查，以明确并描述其髋关节疾病情况。33例（38%）存在临床髋关节疾病，通常为双侧（91%），且往往在疾病病程早期出现；在整个研究组中，它是导致Ⅲ级和Ⅳ级残疾的50%的原因。典型表现包括局部疼痛、活动受限、肌肉萎缩和屈曲挛缩。42例（48%）出现髋关节放射学异常。与两个对照组相比，其放射学表现具有特征性，包括股骨头轴向移位（63%）、关节间隙同心性变窄（50%）、股骨粗隆样骨赘形成（36%）和髋臼内陷（30%）。8例患者需要双侧髋关节手术。16例置换髋关节中有8例出现关节周围骨化；在8例髋关节中的5例中，它导致了临床活动障碍。这种潜在的严重并发症可能会限制髋关节置换术在某些AS患者中的应用。
