Kaouther Maatallah1, Ines Mahmoud2, Safa Belghali3, Kawther Ben Abdelghani4, Olfa Saidane2, Elyes Bouajina3, Ahmad Laatar4, Rawdha Tekaya2, Leila Abdelmoula2. 1. Department of Rheumatology, Kassab Institut Manouba 2010, El Manar Tunis University, Tunisia. 2. Department of Rheumatology Charles Nicolle Hospital, 1006 Bab Souika, El Manar Tunis University, Tunisia. 3. Department of Rheumatology, Farhat Hached Hospital, 4002 Medina of Sousse, Sousse University, Tunisia. 4. Department of Rheumatology, La Marsa Hospital, 2046 Sidi Daoud, El Manar, Tunis University, Tunisia.
Abstract
BACKGROUND: Hip involvement in ankylosing spondylitis (AS) is a common extraspinal arthritic manifestation, which is associated to a worse functional outcome. Little data are available on the effectiveness of conservative treatment strategies. The TNF inhibitors have been proven effective on AS activity parameters. Their structural effect on hip disease however, little is studied. CASE PRESENTATION: We describe four new cases of reparative changes of a damaged hip joint after treatment with TNF inhibitors. The average of age was 32.5 (27- 36) years. There were 3 men and 1 woman. Hip involvement was bilateral in all cases. Etanercept was prescribed in 3 cases and infliximab in 1 case. At baseline, all patients had a painful and limited hip with high disease activity and an important functional impairment. After an average of 5.5 years of treatment with TNF inhibitors, the BASRI hip evaluated in antero-posterior x-rays of the pelvis remained unchanged at 2.4. The average of mean hip joint space was 2.9mm (2.3-3.6). A widening in hip joint space was observed in all cases with less subchondral cysts. CONCLUSION: TNF inhibitors seem to be effective on hip joint disease in patients with AS.
BACKGROUND: Hip involvement in ankylosing spondylitis (AS) is a common extraspinal arthritic manifestation, which is associated to a worse functional outcome. Little data are available on the effectiveness of conservative treatment strategies. The TNF inhibitors have been proven effective on AS activity parameters. Their structural effect on hip disease however, little is studied. CASE PRESENTATION: We describe four new cases of reparative changes of a damaged hip joint after treatment with TNF inhibitors. The average of age was 32.5 (27- 36) years. There were 3 men and 1 woman. Hip involvement was bilateral in all cases. Etanercept was prescribed in 3 cases and infliximab in 1 case. At baseline, all patients had a painful and limited hip with high disease activity and an important functional impairment. After an average of 5.5 years of treatment with TNF inhibitors, the BASRI hip evaluated in antero-posterior x-rays of the pelvis remained unchanged at 2.4. The average of mean hip joint space was 2.9mm (2.3-3.6). A widening in hip joint space was observed in all cases with less subchondral cysts. CONCLUSION: TNF inhibitors seem to be effective on hip joint disease in patients with AS.