Do Radiographs Adequately Detect Hip Osteoarthritis?

A new study suggests that radiographs might not be sufficient in detecting hip osteoarthritis. Patients with hip pain usually receive a radiograph scan to determine whether they have hip osteoarthritis, yet these scans aren’t a reliable way to diagnose patients.

Hip pain and osteoarthritis causes many lifestyle impairments for older adults, many times leading to hip replacement surgery. If more patients were diagnosed with hip osteoarthritis, they could be given the immediate, adequate treatment instead of needing surgery later on.
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For their study, researchers examined data from 2 sources: the Framingham Osteoarthritis Study, which followed 946 patients over a 3-year period, and the Osteoarthritis Initiative, which followed 4366 patients over a 2-year period. Patients reported hip pain frequency and location of the pain. Framingham study patients were also assessed for hip pain with internal rotation.

Each patient took a radiograph scan, which researchers examined to determine whether the radiograph showed hip osteophytes or joint space narrowing—signs of hip osteoarthritis.

The results of the Framingham study showed that 16% of patients with frequent hip pain showed evidence of hip osteoarthritis in their radiogram, and about 21% of patients who had evidence of hip osteoarthritis reported having frequent pain. The results of the Osteoarthritis Initiative study were similar: 9% and 24%, respectfully.

This means that radiographs shouldn’t be the sole evidence to rely on when diagnosing patients with frequent hip pain.

“Most older participants with a high suspicion for clinical hip osteoarthritis…did not have radiographic hip osteoarthritis, suggesting that in many cases, hip osteoarthritis might be missed if diagnosticians relied solely on hip radiographs,” researchers concluded.

—Amanda Balbi

Reference:

Kim C, Nevitt MC, Niu J, et al. Association of hip pain with radiographic evidence of hip osteoarthritis: diagnostic test study.  December 2, 2015.  http://www.bmj.com/content/351/bmj.h5983?etoc.