Cam Type Femoroacetabular Impingement Morphology Is More Frequent in Patients with Axial Spondyloarthritis

Servet Akar¹, Ozgur Tosun², Dilek Solmaz³, Gokay Karaca², Aliye Tosun⁴, Mustafa Ozman⁵ and Fatih Esat Topal⁶, ¹Department of Rheumatology, İzmir Katip Çelebi University, School of Medicine, İzmir, Turkey, İzmir, Turkey, ²Radiology, Izmir Katip Celebi University School of Medicine, izmir, Turkey, ³Rheumatology, Izmir Katip Celebi University School of Medicine, izmir, Turkey, ⁴physical therapy and rehabilitation, Izmir Katip Celebi University School of Medicine, izmir, Turkey, ⁵Rheumatology, Izmir Katip Celebi University School of Medicine, Izmir, Turkey, ⁶Emergency Medicine, Izmir Katip Celebi University School of Medicine, Izmir, Turkey

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: axial spondyloarthritis

Session Information

Date: Tuesday, November 15, 2016

Title: Spondylarthropathies and Psoriatic Arthritis – Clinical Aspects and Treatment - Poster III

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose: Femoroacetabular impingement (FAI) is characterized by early pathologic contact of the proximal femur with the acetabulum. Pincer impingement is the acetabular cause of FAI.Whereas cam deformity seen as a flattening of the anterior contour of the head/neck junction or an osseous hump leading a decreased femoral head/neck offset. Patient with FAI presents with a hip or a trochanteric pain usually in the sitting position or during or after activity. It might also be an important cause of hip osteoarthritis (OA). Therefore in this study we evaluated the frequency of cam-type FAI in axial spondyloarthritis (axSpA) patients as a potential alternative cause of hip or trochanteric pain.

Methods: A total 180 patients (107 [59%] male, mean age 41.9 ± 12.8 years) with axSpA according to ASAS criteria and 198 patients (120 [61%] male, mean age 40.5 ± 14.8 years) admitted to the emergency department (mostly due to trauma) and who had pelvic X-ray were included in the study.Patients with hip OA, hip prosthesis, acetabular protrusion or who have radiographs taken improper technique were excluded. An experienced radiologist assessed all anteroposterior pelvic radiographs.

Results: The axSpA group consists 135 ankylosing spondylitis and 45 non-radiographic axSpA patients. The mean duration of symptoms was 13.8 ± 11.3 years in axSpA patients. Radiographic findings of cam abnormality (figure) were significantly more frequent in axSpA patients in comparison with control subjects (30/150 [20%] vs 17/193 [9%] and P=0.004). Cam-type radiographic abnormality was only present 2 female control subjects and none of female axSpA patients. FAI was significantly correlated with the presence of HLA-B27 (r=0.213 and P=0.048), smoking (r=0.194 and P=0.018), height (r=0.283 and P=0.001) and gender (r=0.443 and P<0.001).

Conclusion: This study for the first time showed that radiographic findings compatible with cam-type FAI were frequent in axSpA patients. In addition to repetitive injury to the proximal femoral physis, new bone formation may be responsible for increased FAI in axSpA. In axSpA patients with hip or trochanteric pain, FAI may be kept in mind as an alternative explanation of the symptoms.

Disclosure: S. Akar, None; O. Tosun, None; D. Solmaz, None; G. Karaca, None; A. Tosun, None; M. Ozman, None; F. E. Topal, None.

To cite this abstract in AMA style:

Akar S, Tosun O, Solmaz D, Karaca G, Tosun A, Ozman M, Topal FE. Cam Type Femoroacetabular Impingement Morphology Is More Frequent in Patients with Axial Spondyloarthritis [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/cam-type-femoroacetabular-impingement-morphology-is-more-frequent-in-patients-with-axial-spondyloarthritis/. Accessed .

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