Idiopathic chondrolysis of the hip

Segaren, Neil; Abdul-Jabar, Hani B.; Segaren, Nicholas; Hashemi-Nejad, Aresh

doi:10.1097/bpb.0000000000000019

Cited by 16 publications

(10 citation statements)

References 29 publications

(64 reference statements)

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“…16 This evidence suggested that the development of the disease may be the result of autoimmune-mediated cartilage destruction in patients. 3 Recombinant human tumor necrosis factor (rhTNFR) is a tumor necrosis factor (TNF) antagonist that reduces the activity of TNF-α by competitively binding to it in the blood and blocking its binding to TNF receptors on the cell surface, which in turn blocks the release of inflammatory factors and controls the progression of inflammation during the treatment of joint inflammation. [17][18][19][20] In our group, seven patients tried to use rhTNFR.…”

Section: Original Clinical Articlementioning

confidence: 99%

“…The natural course of ICH is divided into two stages: an acute phase lasting approximately 18 months (characterized by active inflammation within the synovial lumen of the hip, resulting in hip pain and limited range of motion due to progressive destruction of the articular cartilage on both sides of the joint) and a chronic inflammatory phase lasting 3–5 years. 2 Segaren et al 3 described three possible clinical outcomes: complete disappearance of symptoms, painless but stiff hip, and pain with hip ankylosis. The latter two are common occurrences.…”

mentioning

confidence: 99%

“…16 This evidence suggested that the development of the disease may be the result of autoimmune-mediated cartilage destruction in patients. 3…”

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confidence: 99%

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Diagnosis and treatment of 10 cases of idiopathic chondrolysis of the hip

Guan

Zhao

Xiong

et al. 2022

Journal of Children's Orthopaedics

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Objective: To analyze the clinical characteristics, X-ray and magnetic resonance imaging manifestations, and treatment efficacy of idiopathic chondrolysis of the hip. Methods: Ten patients with idiopathic chondrolysis of the hip treated at our hospital from September 2013 to April 2022 were collected, and their clinical features, X-ray and magnetic resonance imaging manifestations, and treatment outcomes were analyzed. Results: Their main clinical features included single hip pain, claudication gait, and pelvic tilt, without specific clinical symptoms and signs. Laboratory tests such as blood analysis, erythrocyte sedimentation rate, C-reactive protein, rheumatoid factor, autoimmune test, coagulation function, interferon release test for tuberculosis infection, and tuberculosis antibody test were normal. In the late stage, the imaging shows degeneration or ankylosis of the joint. The disease progresses rapidly, and joint degeneration can occur in adolescence without effective treatment. Herein, seven patients were treated with recombinant human tumor necrosis factor receptor–antibody type II fusion protein. Among them, four (according to Camarnat magnetic resonance imaging classification, three were Stage I and one was Stage II) showed improved symptoms and function, while two (Stage III) had progressed. One patient (Stage I) who received recombinant human tumor necrosis factor receptor had no significant relief of symptoms, for whom anterior capsular release surgery significantly improved the hip joint motion. Of the four patients who underwent hip release surgery, three showed progression. Conclusion: Idiopathic chondrolysis of the hip has no specific clinical and laboratory tests and a high misdiagnosis rate. Thus, early magnetic resonance imaging is a critical reference for diagnosis. We recommend that patients with magnetic resonance imaging Stage II or earlier be actively treated with recombinant human tumor necrosis factor receptor and start treatment as early as possible. In the third stage, the treatment effect is mediocre, and the narrowed hip space is difficult to change.

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Section: Original Clinical Articlementioning

confidence: 99%

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confidence: 99%

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Diagnosis and treatment of 10 cases of idiopathic chondrolysis of the hip

Guan

Zhao

Xiong

et al. 2022

Journal of Children's Orthopaedics

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“…ICH affects females six times more commonly than males and is mostly unilateral [ 6 , 8 , 12 ]. The average age at the onset of the disease is 11 and ranges from 3-20 years of age with almost even distribution worldwide [ 3 , 4 , 7 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Idiopathic Chondrolysis of the Hip in Two Adolescent Females: A Six-Year Follow-Up

Kawas,

Alam,

Hamad

2023

Cureus

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Idiopathic chondrolysis of the hip (ICH) is a rare condition with only a few cases reported in the literature. The average age at the onset of the disease is 11 years, with females having six times higher incidence than males. We report two cases of ICH in two medically free 10-year-old females who presented with atraumatic insidious hip pain and limping. No significant past medical, surgical, or family history was recorded. Laboratory studies were within normal limits, and the imaging showed the pathogenic changes of hip chondrolysis. Both cases were treated conservatively, and regular follow-ups in the clinic showed progressive limitation of the hip range of motion with arthritic changes on plain radiographs. Altogether, ICH is rare and can be misdiagnosed as inflammatory or infectious hip arthritis. Clinical assessment and image interpretation can lead to early diagnosis. Pain management and physical therapy with a prolonged period of protected weight-bearing are the mainstays of treatment.

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“…It begins with disruption of the capital growth plate and culminates with the displacement of the proximal femoral metaphysis from the capital femoral epiphysis 1 , 2 . Several sequelae typically occur after a SCFE, and these include residual proximal femoral deformity, coxa vara, and lower limb length discrepancy (LLD) 3 , 4 . Regarding the biomechanics of coxa vara, the forces on the hip are converted to shearing rather than compressive forces.…”

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confidence: 99%

Fixator-Assisted Nailing for Managing Slipped Capital Femoral Epiphysis Sequelae: A Novel Technique

Hashem

Alatassi

2020

JBJS Case Connector

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Case: An 18-year-old man with a slipped capital femoral epiphysis treated within in situ screw fixation 5 years earlier presented to our clinic with hip pain, limping, and limited range of motion (ROM) of the left hip. Fixator-assisted nailing (FAN) accompanied by double femoral osteotomies was performed to treat the proximal femoral deformity. At follow-up, the patient had regained full ROM and acceptable alignment of the left lower limb. Conclusion: The FAN approach effectively manages proximal femoral deformities in select patients. It requires careful analysis of the deformity, meticulous preoperative planning, and surgeons familiar with both intramedullary nailing and external fixation techniques.

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Idiopathic chondrolysis of the hip

Cited by 16 publications

References 29 publications

Diagnosis and treatment of 10 cases of idiopathic chondrolysis of the hip

Diagnosis and treatment of 10 cases of idiopathic chondrolysis of the hip

Idiopathic Chondrolysis of the Hip in Two Adolescent Females: A Six-Year Follow-Up

Fixator-Assisted Nailing for Managing Slipped Capital Femoral Epiphysis Sequelae: A Novel Technique

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