Rapidly destructive articular disease

Rapidly destructive articular disease refers to the rapidly progressive osteoarthritis and destruction of the hip, typically seen in elderly women. The disease is almost always unilateral, but bilateral hip and concomitant shoulder involvement have also been reported.

Destruction of the hip is usually seen an average of 14 months after the onset of symptoms; however, no significant osteonecrosis, inflammatory change, bacteria or crystals are seen on histological evaluation.

Radiographs reveal progressive loss of joint space and subchondral bone. Eventually, there is flattening and deformity of the femoral head and superolateral subluxation of the femoral head. Mild sclerotic changes may be seen; however, there is minimal or absent osteophytosis.

Differential considerations include

• Osteonecrosis
• Septic arthritis
• Neuroarthropathy
• Crystal-induced arthropathies

References

Llauger J, Palmer J, Rosón N, Bagué S, Camins A, Cremades R. Nonseptic monoarthritis: imaging features with clinical and histopathologic correlation. Radiographics. 2000; 20 Spec No:S263-278.