Disappearing Acts: The Many Causes of Rapidly Destructive Arthritis

Porrino, Jack; Carlson, Blake; Kani, Kimia Khalatbari; Mulcahy, Hyojeong; Wyatt, Alvin R.; Chew, Felix S.

doi:10.1067/j.cpradiol.2016.02.012

Cited by 8 publications

(5 citation statements)

References 64 publications

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“…Charcot's joint (neuropathic osteoarthropathy) and RDA have similarities in the slight clinical signs with serious imaging manifestation. Diabetes mellitus is the leading cause of neuropathic osteoarthropathy, with additional associations including syringomyelia, meningomyelocele and multiple sclerosis (36). It is easy to mistake RDA symptoms for symptoms of rheumatoid arthritis, septic arthritis, osteonecrosis of the femoral head, seronegative arthritis or osteoarthritis.…”

Section: Discussionmentioning

confidence: 99%

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The mysteries of rapidly destructive arthrosis of the hip joint: a systemic literature review

Hu¹,

Zhang²,

Kourkoumelis³

et al. 2020

Ann Palliat Med

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Rapidly destructive arthrosis (RDA) is considered a rare and poorly diagnosed disease but is now seen more frequently in practice due to ageing populations. The most typical radiological features are flat femoral heads, absence of articular cartilage, subchondral bone destruction and signs of joint effusion.These features could be found on X-ray or magnetic resonance imaging (MRI). Surgeons should consider the presence of RDA when patients show rapid femoral head destruction. The purpose of this study is to review the distinct clinical features and successful treatments which may lead to the diagnosis and early handling of RDA. A comprehensive review of the literature was undertaken using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines with no language restrictions. Overall 23 publications with 17 detailed cases of RDA met the inclusion criteria. We found that the only prevalent factors associated with RDA were: (I) age greater than 60 years; (II) female gender; (III) presence of underlying systemic diseases such as rheumatoid arthritis, diabetes mellitus or systemic lupus erythematosus.Further studies should be conducted to clarify the histopathology and define the diagnosis as well as the treatment.

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Section: Discussionmentioning

confidence: 99%

“…Because of the intractable severity of pain, two patients underwent a total hip replacement (2,9). Twelve patients were reported to have 38.3±3.07 (range, [33][34][35][36][37][38][39][40][41][42] points in the Harris Hip Score (15). Two patients were unable to walk because of the pain (8,11).…”

Section: Symptoms and Signsmentioning

confidence: 99%

The mysteries of rapidly destructive arthrosis of the hip joint: a systemic literature review

Hu¹,

Zhang²,

Kourkoumelis³

et al. 2020

Ann Palliat Med

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“…Hence the distinction of RDO from these other disorders is important for the understanding of the RDO process. 17 Examples include septic arthritis, neuropathic osteoarthropathy, ON, crystal induced arthropathy, and hyaluronic acid crystal induced arthropathy. More rare associations include amyloid arthritis, ochronosis, rheumatoid arthritis, psoriatic arthritis, and SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis).…”

Section: Rapidly Destructive Osteoarthritis Of the Hipmentioning

confidence: 99%

Circulation in Rapid Hip and Knee Bone Destruction

Nelson

2017

J Hip Surg

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In the hip and knee, the term subchondral insufficiency fracture has been used to describe a focal bone response associated with sudden onset of joint pain, older age, focal osteoporosis, and progression to joint replacement in some cases. Rapidly developing osteoarthritis of the hip is also associated with sudden onset of severe pain, and it usually progresses to larger areas of bone resorption with progression to joint replacement. The literature relative to these three conditions was reviewed focusing on patient demographics, imaging, osteoporosis, associated comorbidities, cytokine changes, similar vascular disorders in other joints, and attempts at nonsurgical treatment. These conditions predominate in, but are not restricted to, individuals who are older than 50, have physical joint abnormalities, are not systemically osteoporotic, and have had no apparent trauma. The biochemical and genetic mechanisms for hip and knee insufficiency fractures is not clear. Although there are reports of hip subchondral insufficiency fractures associated with rapidly developing osteoarthritis of the hip, it is not clear whether all cases are preceded with insufficiency fractures. There is insufficient information on the fracture healing mechanism of insufficiency fractures, and the relationship to vascularity and biochemical imbalance is poorly understood. It is concluded that there are large gaps in the knowledge of biochemical and other mechanisms that might link these conditions. This knowledge may influence nonsurgical treatment strategies.

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“…In light of the increasing recognition of RPOH, many studies have attempted to identify a cause despite which its aetiology remains unclear [ 7 – 9 ]. It has been suggested that subchondral insufficiency fractures (SIFs) contribute to the development of RPOH, although this remains unproven [ 9 – 11 ]. The patient is more commonly female, older than the typical osteoarthritic patient, and with unilateral disease [ 8 , 12 – 14 ].…”

Section: Introductionmentioning

confidence: 99%

The outcomes of total hip arthroplasty in rapidly progressive osteoarthritis: a systematic review

Baryeh

Asopa

Field

et al. 2022

Eur J Orthop Surg Traumatol

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Purpose Rapidly progressive osteoarthritis of the hip is an uncommon and poorly understood condition. No universal definition of RPOH exists, however, a loss of joint space of 2 mm or more per year or 50% or more in one year with no other cause can be classed as RPOH. Due to the rapid loss of joint space and associated bone loss, total hip arthroplasty is the only viable treatment option. The aim of this systematic review is to assess the outcomes of THA in RPOH. Methods A systematic search of Embase, Medline and CINAHL databases was performed for studies reporting on the outcomes of patients with RPOH as their primary diagnosis for undergoing THA. Patient demographics, surgical techniques, implant selection, blood loss, morbidity and mortality, length of stay and patient-reported outcomes were amongst the data collected. Results Eight studies were found to be eligible, reporting on the outcomes of 270 patients with a mean age of 71. The majority of patients (88.1%) were female and the mean Body Mass Index was 27.6 kg/m 2 . Six of the eight studies reported on the need for additional reconstructive devices and procedures including the use of acetabular roof augmentation, acetabular reinforcement devices and revision acetabular components. Two studies reported increased blood loss in RPOH patients compared with non-RPOH patients (945 ml vs. 578 ml and 473.9 g vs. 353.9 g, respectively). Conclusion RPOH leads to significant pre-operative morbidity and THA for RPOH has been shown to result in greater blood loss, prolonged operative time and increased complexity of the procedure all of which result in increased cost. There is a paucity of data on the long-term outcomes for these patients and more well-constructed studies are therefore required.

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Disappearing Acts: The Many Causes of Rapidly Destructive Arthritis

Cited by 8 publications

References 64 publications

The mysteries of rapidly destructive arthrosis of the hip joint: a systemic literature review

The mysteries of rapidly destructive arthrosis of the hip joint: a systemic literature review

Circulation in Rapid Hip and Knee Bone Destruction

The outcomes of total hip arthroplasty in rapidly progressive osteoarthritis: a systematic review

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