PSEUDO-SEPTIC HIP ARTHRITIS AS THE PRESENTING FEATURE OF JUVENILE ANKYLOSING SPONDYLITIS: A CASE REPORT

Dr JAYDEEP NANDI; Dr ABHISHEK CHOWDHERY

Volume : V, Issue : VII, July - 2016

PSEUDO-SEPTIC HIP ARTHRITIS AS THE PRESENTING FEATURE OF JUVENILE ANKYLOSING SPONDYLITIS: A CASE REPORT

Dr Jaydeep Nandi, Dr Abhishek Chowdhery

Abstract :

Background: Juvenile onset AS differs from the adult form of the illness in that peripheral joint (like hip) arthritis is much more common and can precede, by many years, the onset of inflammatory back disease. Case characteristics: A young male patient of 15 years started having hip pain (Right>Left) associated with limping. Initially he was diagnosed as a case of right side TB hip but anti tubercular therapy failed to improve his symptoms. After about 3 years he was again diagnosed as bacterial septic arthritis, this time of the left hip and managed for that. Finally the diagnosis of Juvenile Onset Ankylosing Spondylitis (AS) was made based on modified New York criteria. Intervention: Emphasis was placed on the importance of long term home exercise program. Outcome: At a 2-month follow-up visit, the patient gained significantly in his ease of performing activities of daily living. Also he was referred for surgical spinal osteotomy for kyphosis correction and/or bilateral total hip replacement. Message: Pseudo septic hip arthritis as the presenting features of AS has been quite rare but may be expected in the juvenile onset variant. Abeviation: AS: Ankylosing spondylitis , B/L: Bilateral , TB: Tuberculosis , ATD: Anti-tubercular drugs ,CRP: C Reactive Protein ,ESR: Erythrocyte Sedimentation Rate, HLA: Human Leucocyte Antigen ,TNF: Tumor Necrosis Factor ,ROM: Range of motion ,SI Joint: Sacro-iliac Joint, MRI: Magnetic Resonance Imaging , DL Spine: Dorso-lumbar Spine