Hip involvement in ankylosing spondylitis

Case contributed by Utkarsh Kabra
Diagnosis certain

Presentation

Chronic backache, presently pain in right hip

Patient Data

Age: 25 years

Acute erosions with subchondral marrow edema are seen along sacral and iliac articular aspects of right sacroiliac joint.

Irregularity, chronic erosions along articular aspects of left sacroiliac joint with significant sclerosis along left iliac articular aspects, likely bilateral sacroilitis.

Subchondral erosions, marrow edema is seen involving right acetabulum and femoral head with marginal osteophytes along articular aspects. Reduced right hip joint space with partial articular cartilage loss. Mild right hip joint effusion is seen, suggesting inflammatory arthritis.

Marrow edema is seen involving right superior pubic ramus with surrounding soft tissue edema. Marrow edema involving multiple dorsal costovertebral and costotransverse joints, likely enthesitis.

Case Discussion

Overall findings suggest likelihood of ankylosing spondylitis with right hip joint involvement.

The patient was found to be HLA-B27 positive.

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