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Two Cases of Rheumatoid Arthritis that Exhibited Bilateral Hip Joint Destruction since Early Stage of Onset

Masato Kamiya, Kenji Yamazaki, Seishi Mori, Teppei Murakami and Satoshi Soen

Here, we report two cases of rheumatoid arthritis (RA) that exhibited bilateral hip joint destruction since early stage of onset. Both patients were postmenopausal women. Arthritis developed at the right shoulder joint while the patient was on non-steroidal anti-inflammatory drugs and pain in the right shoulder joint was relieved. However, she subsequently developed bilateral destruction of the hip joints with acetabular dysplasia, which progressed rapidly during the next 6-12 months, for which she had to undergo bilateral total hip arthroplasty. Our second case featured bilateral hip joint destruction. Despite the single administration of methotrexate and the subsequent use of biological products, the efficacy of this treatment gradually weakened. However, the biological product used as the fifth agent was effective, and the progression of joint destruction was suppressed for 3 years until the final examination. RA rarely occurs in the hip joints in the early stage of the disease, but when it does, the process of joint destruction may progress rapidly in patients with a morphological abnormality such as acetabular dysplasia. Therefore, when hip arthralgia appears, it is necessary to perform morphological evaluation by X-ray photography and follow-up in parallel with active treatment using disease-modifying anti-rheumatic drugs.