The mysteries of rapidly destructive arthrosis of the hip joint: a systemic literature review

Rapidly destructive arthrosis (RDA) is considered a rare and poorly diagnosed disease but is now seen more frequently in practice due to ageing populations. The most typical radiological features are flat femoral heads, absence of articular cartilage, subchondral bone destruction and signs of joint effusion. These features could be found on X-ray or magnetic resonance imaging (MRI). Surgeons should consider the presence of RDA when patients show rapid femoral head destruction. The purpose of this study is to review the distinct clinical features and successful treatments which may lead to the diagnosis and early handling of RDA. A comprehensive review of the literature was undertaken using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines with no language restrictions. Overall 23 publications with 17 detailed cases of RDA met the inclusion criteria. We found that the only prevalent factors associated with RDA were: (I) age greater than 60 years; (II) female gender; (III) presence of underlying systemic diseases such as rheumatoid arthritis, diabetes mellitus or systemic lupus erythematosus. Further studies should be conducted to clarify the histopathology and define the diagnosis as well as the treatment.