1.Why is “hip joint lesion” often misdiagnosed as “femoral head necrosis”? The reason why I put this question in front of you is that there are misunderstandings among patients. The two diseases are essentially two different things. However, the films and symptoms are quite similar. Many physicians, especially orthopedic surgeons, do not know enough about “hip lesions”, and because they have been exposed to a large number of cases of “femoral head necrosis” for a long time, they tend to have preconceived ideas and confuse the two. ”Femoral head necrosis is mostly caused by long-term hormones, alcohol consumption and trauma, and the main pathology is “ischemia and necrosis of the bone”. But hip joint lesions, in addition to the “bone inflammation”, the surrounding muscles and ligaments are also affected by inflammation, resulting in muscle atrophy and contracture. The difference between the two is of great significance to the treatment. 2.How high is the incidence of hip joint lesions? A: About 30-50% of patients will eventually develop hip joint lesions of varying degrees. There are large regional differences, and the incidence of AS in China is significantly higher than that in other countries. According to a survey conducted by the author’s unit, in the southern region of China, about 9% of AS patients have hip lesions as their first symptom. About one-third of the patients with hip lesions have osseous ankylosis of the hip joint, and the proportion is higher in rural, mountainous and backward areas. 3.Who is prone to hip joint lesions? A. Those who are younger (e.g. <22 years old) at the onset of the disease, B. Those whose father or mother or close relatives also have AS, C. Those who have peripheral arthritis such as knee and ankle joints at an early stage, D. Those who have a slightly higher incidence of hip arthropathy than men and whose condition is more severe, E. Those who have prolonged and significant abnormalities in inflammation indicators. 4. Is there a "risk period" for the occurrence of hip lesions? A: According to incomplete statistics, about 90% of hip lesions occur within 5 years of onset, and the vast majority occur within 10 years of onset. Therefore, if the 5-year or even 10-year "risk period" is passed, the chance of hip lesions is very small. Therefore, old patients do not need to worry. 5.What are the possible symptoms and hazards of hip arthrosis? The early symptoms include pain in the hip, groin, inner thigh and hip, which is mostly severe. Then the hip joint movement is restricted, the joint muscles atrophy, and finally bony ankylosis (which may be accompanied by serious osteoporosis), and difficulty in living and living, which is the main cause of disability in AS. For example, nine years ago, our department went to a mountainous county in Guangdong to investigate and found that more than 85% of the disabilities caused by AS were due to this. Many patients eventually had to undergo "hip replacement" to restore some of their functions. In addition to the physical pain and financial burden, patients who need "joint replacement" at a young age will inevitably need to be "repaired" in the long run. "The rope is broken and the stone is worn out", even if the artificial prosthesis is strong, it will inevitably wear out day after day. The muscles and ligaments around the hip joint atrophy and contracture due to inflammation, which also restrict the function and service life of the joint after replacement. In addition, if the disease develops quickly and requires joint replacement prematurely, their education, employment, marriage and childbirth will be affected to a certain extent. 6.How should hip joint lesions be treated? A: Early and active treatment is especially important. The rate of hip joint destruction should be slowed down as much as possible to avoid or delay hip joint replacement surgery. If the muscles around the joint are also well protected, even if the joint has to be replaced later, the surgical result is relatively good. From the viewpoint of our practice, most of the patients can be satisfactorily controlled by active treatment within 1 or 2 years; some of the female patients can even achieve the purpose of stopping the medication for marriage. Specific medication: NSAIDs (anti-inflammatory and analgesic drugs) are far from sufficient to control the disease. Hormones can be used for intra-articular injections, which can temporarily improve symptoms, but are not advocated for oral or intravenous use. Disease-modifying anti-rheumatic drugs (DMARDs) such as lorazepam, methotrexate, and thalidomide have low to moderate efficacy and can moderate joint destruction. Biological agents are effective, but expensive, because there are many types of biological agents, each with its own pharmacological characteristics, so they should be used according to the individual and reasonable. Some proprietary Chinese medicines have adjuvant effects, but their overall efficacy is limited, and their side effects should be noted.