Hip involvement in seropositive rheumatoid arthritis - Survivorship analysis with a 15-year follow-up

In a prospective survey of recent arthritis 96 patients had erosive and ser opositive rheumatoid arthritis (RA). Severe radiological changes in the hip joint (Larsen grade 3 - 5) were observed in 31 (32%) and acetabular protru sion in five (5%) patients 15 years after the onset of arthritis. At the en d of follow-up Larsen score 0 - 100 of peripheral joints (p <0.015), HAQ (p < 0.001). ESR (p < 0.001), and CRP (p <0.01) were significantly higher in patients with hip joint destruction than in those without. Secondary amyloi dosis was found in eight patients with and in three patients without hip in volvement (p = 0.002). In survivorship analysis (the Larsen 0 - 2 grade hip s) an overall predicted rate of survival was 80% after 14 years of rheumato id arthritis. When analyzed according to HLA-B27 the rate of radiological s urvival for the patients with a positive test was 62% and 87% for the other s (p = 0.02). In conclusion, RA patients with high number of destructive pe ripheral joints (Larsen score) and high ESR or CRP should be carefully moni tored due to the increased risk of hip destruction.