Rapidly destructive osteoarthritis of the hip

Last revised by Henry Knipe on 14 Oct 2024

Rapidly destructive osteoarthritis of the hip, also known as rapidly progressive osteoarthritis of the hip, is a rare chondrolysis of unknown etiology which can progress to complete destruction of the femoral head. It is a diagnosis of exclusion.

It is most common in 60-70 year old females 4.

Rapidly destructive osteoarthritis of the hip has been defined as >2 mm/year joint space narrowing or >50% joint space loss in 1 year with no evidence of an underlying cause 1,4.

Hip pain is the most frequently encountered symptom. In most cases, hip pain is present on average for ~1.5 years (range 6-36 months) 2.

The etiology and pathophysiology is unclear 4.

Initial x-rays may be normal or show mild osteoarthritis with progressive rapid joint space narrowing with or without femoral head destruction 4. Flattening of the femoral head with subchondral sclerosis and geodes are common with marginal osteophytes generally absent or small 4. There may be joint subluxation 4.

Described features include:

The typical treatment is total hip arthroplasty ref.

The differential diagnosis includes:

Cases and figures

  • Case 1: on presentation
  • Case 1: 6 months later
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