Correlative Study Of Imaging Findings And Clinical Teatures Of Hip Involvement In Patients With Ankylosing Spondylitis

Objective: Through the result analysis of the AS patients’ general information, clinical manifestation,laboratory examination, imaging examination, diagnosis and treatment etc, to explore the value and the correlation between imaging findings and clinical features on different imaging examination in the diagnosis of AS patients’ hip involvement.Methods: To collect patients’ general information, clinical manifestation, laboratory examination and imaging examination(pelvic X-ray plain film, CT and MRI of the hip), such information like diagnosis and treatment, t-test and chi-square test ware used to analyze the results.Results: 117 AS patients’ 234 hip, X-ray plain film and MRI showed abnormal of 46 sides and 151 sides respectively; X-ray plain film change include: the narrow gap: 34 sides, uneven density of the femoral head:15 sides, Bone destruction: 20 side, bone sclerosis: 10 side, bone hyperplasia, 8 side; MRI showed that joint effusion: 110 side, synovial thickening: 12 side, synovial reinforcement: 21 side, bone marrow edema: 79 side, tendon end inflammation: 1 side, bone destruction: 15 side, narrow gap: 10 side, fat deposition: 4 side.CT examination in 88 cases, 176 side hip, and display abnormal of 60 side, in X-ray plain film of CT and MRI showed bone destruction at the same time, 35 side bone destruction and 43 side bone destruction,failed to display respectively in X-ray plain film and MRI. X-ray plain film, CT and MRI showed abnormal were 18.8%(33/176), 34.1%(60/176) and 63.6%(112/176), MRI showed that the sensitivity of the hip joint involvement is superior to X-ray plain film and CT(X2 value was 73.19 and 73.19, respectively, P values < 0.05). MRI in addition to the X-ray plain film and CT can display the chronic bone structure change, also found that the X-ray plain film and CT failed to show an acute inflammatory change. In addition to patients wo has no chronic bone structural changes,patients wo have chronic bone structural changes have younger age,higher BASFI,shorter disease duration and more pain or limitation of the movement during the course(P < 0.05).Hip pain or limited movement of patients are more likely to appear imaging chronic hip bone structure destruction, more likely to see a doctor and accept regular specialized care.Conclusion: The imaging examination in the diagnosis of AS hip involvement, pelvic X-ray plain film can be used as the screening examination, but only found in the middle-late lesions; On the display of AS hip suffers from chronic bone structure changes, CT is superior to X-ray plain film and MRI; MRI can display the acute inflammation which X-ray plain film and CT can’t display. Patients who has the property of younger, short duration,high BASFI and hip pain or restricted movement in history are more likely to have chronic bone structure change; Hip pain or limited movement of patients are more likely to appear imaging chronic hip bone structure destruction, more likely to see a doctor and accept regular specialized care.Reasonable use of imaging examination, combined with clinical, early diagnosis, early treatment of AS hip joint involvement, so as to reduce morbidity, and improve the prognosis of patients with AS.