8 炎症性腸疾患に伴う股関節疾患(シンポジウム炎症性腸疾患の病因と治療の進歩)(第578回新潟医学会)

概要

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Hip arthropathies are relatively rare extra-intestinal complications of inflammatory bowel diseases, such as ulcerative colitis or Crohn's disease. We investigated hip arthropathies of six patients accompanying ulcerative colitis. These arthopathies were classified into three categories as follows, "peripheral arthritis", "spondylo-arthropathy", and "steroid-induced idiopathic osteonecrosis of the femoral head". Peripheral arthritis belongs to sero-negative arthritis related to several autoimmune diseases. Spondylo-arthropathy is similar to those of ankylosing spondylitis or diffuse idiopathic skeletal hyperostosis. These two arthropathies were treated conservatively and healed without any complications. MR images were quite useful to separate these two entities from osteonecrosis or septic arthritis. All two patients with steroid-induced osteonecrosis had to undergo surgical treatments. To make early diagnosis and prevent collapse of the femoral heads, we routinely screen hip MR images of the steroid treated patients at 3 and 6 months after the steroid administration. Vascularized iliac bone graft and anterior rotational intertrochanteric osteotomy are surgical options to prevent progress of the femoral head deformity, which will cause osteoarthritis. We are now making efforts to establish a new promising gene therapy using electroporation to transfect a gene providing neo-vascularization in the osteonecrotic tissues.
新潟大学の論文