Mayuri Karela1, Lloyd Rickard2, Euthalia Roussou1,2. 1. Barking Havering and Redbridge University Hospitals NHS Trust, Rheumatology and Rehabilitation, King George Hospital, Ilford, United Kingdom. 2. Barts and The London School of Medicine and Dentistry, London, United Kingdom.
Abstract
INTRODUCTION: The item 'hip pain' is widely used in questionnaires related to Spondyloarthritis and/or Ankylosing spondylitis (AS), either in clinics with patients being physically present or remotely, as the hip joint is known to affect AS in particular. Patients in clinics often claim to have hip pain. However, by stating "hip" they are referring to variable structures located in the hip region not necessarily related to hip joint itself. OBJECTIVE: To assess which structure(s) patients mean when referring to hip pain. METHODS: A diagram used as a proforma for patients to indicate the site of 'hip pain' following a detailed history and examination was used. Radiological imaging was utilised for those patients with multiple sites or clinically unclear causes of "hip" pain. RESULTS: From 54 patients 7 different anatomical sites described which were: Trochanter, (27.2%), hip joint (20.8%), iliac crests (anterior superior [6.9%], posterior superior [8.3%], and anterior inferior [4.1%]), lumbar spine (8.3%), sacroiliac joint (6.9%). More than 1 sites in the same patient: (17.5%). Diagnoses were: Trochanteric bursitis (27%), osteoarthritis of hip and spine, (25%), enthesitis (22%), sacroiliitis (6.7%), synovitis (5%), fibromyalgia (3.4%), and hip dislocation (1.6%). More than 1 diagnosis in same patient: 9.3%. CONCLUSION: 'hip pain' as an item used in questionnaires must be interpreted with caution.
INTRODUCTION: The item 'hip pain' is widely used in questionnaires related to Spondyloarthritis and/or Ankylosing spondylitis (AS), either in clinics with patients being physically present or remotely, as the hip joint is known to affect AS in particular. Patients in clinics often claim to have hip pain. However, by stating "hip" they are referring to variable structures located in the hip region not necessarily related to hip joint itself. OBJECTIVE: To assess which structure(s) patients mean when referring to hip pain. METHODS: A diagram used as a proforma for patients to indicate the site of 'hip pain' following a detailed history and examination was used. Radiological imaging was utilised for those patients with multiple sites or clinically unclear causes of "hip" pain. RESULTS: From 54 patients 7 different anatomical sites described which were: Trochanter, (27.2%), hip joint (20.8%), iliac crests (anterior superior [6.9%], posterior superior [8.3%], and anterior inferior [4.1%]), lumbar spine (8.3%), sacroiliac joint (6.9%). More than 1 sites in the same patient: (17.5%). Diagnoses were: Trochanteric bursitis (27%), osteoarthritis of hip and spine, (25%), enthesitis (22%), sacroiliitis (6.7%), synovitis (5%), fibromyalgia (3.4%), and hip dislocation (1.6%). More than 1 diagnosis in same patient: 9.3%. CONCLUSION: 'hip pain' as an item used in questionnaires must be interpreted with caution.
Authors: Stephanie O Keeling; Sumit R Majumdar; Barbara Conner-Spady; Michele C Battié; Linda J Carroll; Walter P Maksymowych Journal: J Rheumatol Date: 2012-02-15 Impact factor: 4.666
Authors: J Dawson; L Linsell; K Zondervan; P Rose; T Randall; A Carr; R Fitzpatrick Journal: Rheumatology (Oxford) Date: 2004-02-03 Impact factor: 7.580