Hip-spine syndrome: Diagnostic difficulties
https://doi.org/10.47360/1995-4484-2023-758-762
Abstract
Introduction. Hip-spine syndrome (HSS) is a combination of coexisting hip osteoarthritis (OA) and degenerative lumbar spine stenosis (LSS). Main difficulties in treating patients with HSS are in early diagnostics and in choosing right surgery, because mistakes lead to pain maintenance. Existing diagnostic algorithms show right surgery choosing failure in 15–20%. We present results of examination patients with HSS in our survey.
The aim – to present clinical and instrumental results of examination of patients with hip-spine syndrome.
Materials and methods. We have examined 378 patients with typical pain pattern (buttocks, low back spine, groin and lateral hip) and difficulties in pain source definition. We performed hip X-rays and low back spine MRI.
Due to results we divided patients into three groups – patients with HSS (n=100), with hip OA (n=172) and patients with LSS (n=106). We used Harris Hip Score, Oswestry Disability Index and Visual Analogue Score to determine hip and lumbar spine functional status and pain level.
Results. Patients with HSS had higher (p<0.05) pain levels (76.5±9.1 mm) than patients with hip (68.3±7.9 mm) or lumbar spine pathology (67.4±7.9 mm). Harris Hip Score in patients wirh HSS (52.7±8.1 points) was same as in patients with hip OA (55.5±9.1 points), Oswestry Disability Index in these patients (44.2±7.6%) was same as in patients with LSS (43.2±7.8%).
Conclusion. High pain level and low Harris Hip Score and Oswestry index, along with clinical examination, on first visit can help suspect hip-spine syndrome and recommend both hip and lumbar spine imaging.
About the Authors
A. A. Kargaltsev
V.A. Nasonova Research Institute of Rheumatology
Russian Federation
Competing Interests:
Russian Federation
Alexander A. Kargaltsev.
115522, Moscow, Kashirskoye Highway, 34A
Competing Interests:
None
M. A. Makarov
V.A. Nasonova Research Institute of Rheumatology
Russian Federation
Competing Interests:
Russian Federation
Maksim A. Makarov.
115522, Moscow, Kashirskoye Highway, 34A
Competing Interests:
None
S. A. Makarov
V.A. Nasonova Research Institute of Rheumatology
Russian Federation
Competing Interests:
Russian Federation
Sergey A. Makarov.
115522, Moscow, Kashirskoye Highway, 34A
Competing Interests:
None
A. M. Lila
V.A. Nasonova Research Institute of Rheumatology; Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian Federation
Russian Federation
Competing Interests:
Russian Federation
Alexander M. Lila.
115522, Moscow, Kashirskoye Highway, 34A; 125993, Moscow, Barrikadnaya str., 2/1, building 1
Competing Interests:
None
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Review
For citations:
Kargaltsev A.A., Makarov M.A., Makarov S.A., Lila A.M. Hip-spine syndrome: Diagnostic difficulties. Rheumatology Science and Practice. 2023;61(6):758-762. (In Russ.) https://doi.org/10.47360/1995-4484-2023-758-762
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