CASE REPORT
Acute destruction of the hip joints and rapid resorption of femoral head in patients with rheumatoid arthritis

Authors
Koichiro Yoshino¹, Shigeki Momohara¹, Katsunori Ikari¹, Koichiro Kawamura¹, Takeshi Mochizuki¹, Takuji Iwamoto¹, Yasuo Niki¹, Seiji Saitou¹ and Taisuke Tomatsu¹

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Received: February 9, 2006 Accepted: August 1, 2006

Abstract
We report three rheumatoid arthritis (RA) cases with acute destruction of hip joint and rapid resorption of femoral head. The condition occurred in less than 6 months and closely resembled rapid destructive coxarthrosis. All three patients were postmenopausal women with active RA who had been taking steroids. Two of the patients were taking prednisolone (PSL) of over 20mg as maximum dose per day, and all patients were resistant to disease-modifying anti-rheumatic drugs (DMARDs). Other than the problems of their hip joints, one had a giant bursitis around the pathological side of the hip joint, another had multiple rheumatoid nodules and skin infarction, and the other suffered from insufficiency fracture of the contralateral femoral subcapital lesion. As a result, all of them had total hip arthroplasty. We recommend taking repetitive radiographs for RA patients with continuing severe hip pain.

Key words
Femoral head resorption, Rapidly destructive coxarthrosis (RDC), Rheumatoid arthritis (RA)