DESTRUCTIVE ARTHRITIS OF THE HIP IN CROHN S-DISEASE

Objectives: Destructive arthritis of the hip joint is a rare manifesta tion of Crohn's disease, We evaluated its frequency and clinical featu res in comparison with spondylarthritis and assessed the clinical cour se, Methods: One hundred patients with Crohn's disease were followed p rospectively in search of destructive arthritis of the hip joint, Pati ents with both Crohn's disease and manifestations of inflammatory join t disease hospitalized in three rheumatology units were also evaluated retrospectively. Results: The prevalence of destructive hip disease w as 2% in patients with Crohn's disease, Ten patients had destructive a rthritis of the hip, Three had ankylosing spondylitis, 5 had spondylar thritis not responding to the criteria of ankylosing spondylitis and 2 had no axial joint disease, In all patients, signs of hip joint disea se were a narrowed intra-articular space, bone condensation, osteophyt osis and features of joint destruction, Manifestations were similar to those in patients with hip joint disease related to idiopathic ankylo sing spondylarthritis, The clinical course was poorly controlled by an ti-inflammatory drugs or treatment of the inflammatory bowel disease, Synoviortheses were required and were effective in most cases, Total h ip replacement was required in 3 cases, Conclusion: Destructive arthri tis of the hip in patients with Crohn's disease is a rare complication causing severe functional impairment further handicapping the patient with a chronic bowel disease.