In 119 consecutive inpatients with rheumatic diseases--mainly rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis--both hips were routinely investigated by sonography.
In 52 of the 119 patients definite or possible pathological findings (in 18 cases bilateral) were observed. The relative frequency of sonographic findings in 223 evaluable hips was 33% and was somewhat higher in patients with rheumatoid arthritis than in those with other diagnoses. Changes were found significantly more often when the patient had joint complaints, limitation of movement, pathological X-ray changes or serological signs of inflammation (elevated ESR, positive C-reactive protein). The relative frequencies were higher than were expected on the basis of data in the literature. Of the pathological sonographic findings, 22% occurred in clinically and radiologically asymptomatic patients.
In view of the therapeutic consequences and the importance of early treatment, routine sonographic examination of the hip joint is recommended.