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Poster: 33Rapidly Destructive Arthropathy of the Hip (RDAH): Clinical, Radiologicaland Pathological Evaluation*Mahmoud Hafez - October 6th - Cairo, EgyptDavid Nag - Hull Royal Infirmary - Hull, United KingdomVicky J. Jowett - Hull Royal Infirmary - Hull, United KingdomFrank R. Howell - Hull Royal Infirmary - Hull, United Kingdom*Email: mhafez@msn.comObjective. To present the common features of a subset of advanced cases of RDAH and providea diagnostic algorithm. Design and Patients. We retrospectively reviewed the clinical,laboratory, imaging and pathological features of advanced cases of RDAH in 12 patients (14hip joints). These patients presented with marked destruction of the hip joints over a shortduration mimicking serious conditions as sepsis, Charcot or neoplasia. Results. The commonfeatures for this subset of RDAH were pain (without stiffness), shortening of the affected leg,severe bone loss of the femoral head and acetabulum, a propensity for subluxation, lack ofosteophytes and predominantly lateral disease. Prolonged usage of strong NSAIDs was acommon association. All patients eventually underwent total hip arthroplasty (THA) except onepatient who was unfit for surgery. Conclusions. Advanced cases of RDAH are an entity thatdeserves wider recognition if only to emphasise that severe radiological damage is not alwayscaused by infection, Charcot or malignancy. The common features are identified and adiagnostic algorithm is proposed to help avoiding undue investigations and expedites THAbefore further loss of bone stock.Figures: Fig. 1 [A & B]: [A] RDAH in case 1 with complete loss of the femoral head over 2weeks time, between presentation and time of surgery. [B] RDAH in case 2 with progressiveerosion over 3-month period then complete loss of the femoral head and neck in a week time.FiguresFigure 1 Figure 2file:///E|/ISTA2010-Abstracts.htm[12/7/2011 3:15:47 PM]