J Manipulative Physiol Ther. 1993 Nov-Dec; 16(9): 601-4.

Destructive arthritis of the hip in a patient with Crohn's disease.

Tibbles AC, Mierau DR, Sibley J.

Canadian Memorial Chiropractice College, Toronto.

OBJECTIVE: Isolated destructive peripheral arthropathy is a rare complication of Crohn's disease. We describe the clinical course and radiographic findings of such a case. CLINICAL FEATURES: A 28-yr-old male presented to our chiropractic clinic with chronic left hip pain. The patient was known to have Crohn's disease. Five years earlier the gastrointestinal symptoms resolved with a brief course of prednisone. However, the left hip pain continued. A radiograph of the left hip was read as normal. Repeat radiograph, 2 yr later, revealed destructive changes of the left hip and, in retrospect, early destructive changes could be seen on the initial radiograph. INTERVENTION AND OUTCOME: The diagnosis, in this case, was destructive arthritis of the left hip secondary to Crohn's disease. The treatment selected in this case was observation and nonsteroidal anti-inflammatory drug use. CONCLUSION: This diagnosis, a relatively rare complication of Crohn's disease, should be considered in a young adult patient with Crohn's disease and persistent peripheral joint pain.