The number of people who had radiographic (X-ray) hip changes was smaller. The authors stated that around 24 to 36 percent of people with AS had clinical hip involvement, meaning they reported symptoms of hip pain. A 2017 Korean study found over 12 percent of participants with AS had hip arthritis. Hip pain with AS can be due to enthesitis or to arthritis in the hip itself. Many people with AS who have hip pain experience it bilaterally, meaning it happens in both hips. In some cases, you may feel pain originating from the hip joints lower down on the legs and knees. When the hips are affected, the pain tends to build gradually. The Spondylitis Association of America reports that about 1 in 3 people with AS experience hip and shoulder pain. People with AS can experience enthesitis in the hips and other sites, including the: The clinical term for inflammation of the areas where tendons and ligaments attach to bones is enthesitis or enthesopathy. This includes the sacroiliac (SI) joint, where the spine connects to the pelvis. The inflammation associated with AS usually first triggers pain in the joints, tendons, and ligaments of the lower spine.
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