ESR <20 mm/h) can be used as an indicator of osteoarthritis 13. Hip joint space width ≤2 mm or <2.5 mm 10-12 or the combination of joint space narrowing with the presence of osteophytes, in particular, in the absence of any elevated inflammatory markers (e.g.
Plain radiographs of the hip are a cheap, widely available and easily obtained modality and their interpretation in the evaluation of osteoarthritis is not as difficult as other imaging modalities 8-10.įor the indication of osteoarthritis of the hip, an anteroposterior radiograph of the hip and a cross-table lateral or frog-leg lateral view are obtained. Subchondral cyst formation and remodeling of the articular surfaces or deformity are seen in more advanced stages. General features are osteophyte formation, joint space narrowing and sclerosis of the subchondral bone plate. Osteoarthritis of the hip can be classified into primary and secondary, depending on whether it is due to a known predisposing factor or not. iatrogenic, e.g. multiple intra-articular steroid injections.The disease not only affects the hyaline cartilage, which loses its structural integrity due to composition changes but also involves the other tissues of the joint including the subchondral bone, the joint capsule and the synovium as well as the ligaments and the periarticular muscles 1. This arises from an imbalance between the destruction and repair of the affected tissues. Osteoarthritis is characterized by an active progressive alteration of the whole synovial joint, due to a combination of mechanical, inflammatory and metabolic factors. Other symptoms include locking, grinding and joint instability, fatigue and pain-related psychological stress 1,8. It can be associated with stiffness particular in the morning or after rest. The pain can be worse at night, at rest or with strenuous activity, reducing the range of motion and limiting walking distance. Patients usually experience slowly progressive hip pain, or hip-related groin pain radiating into the thigh, buttocks or knee. high impact sports (football, handball, hockey, wrestling, weight-lifting, and long-distance running).repetitive stress and mechanical overload.Risk factorsĪttributes, characteristics or exposures that increase the likelihood of developing osteoarthritis of the hip are 3-5,26: The lifetime risk of symptomatic hip osteoarthritis in people reaching the age of 85 years was estimated to be as high as 25% in certain regions 2. Reported prevalence varies in different studies and is also subject to geographic conditions. Women are more commonly affected than men. It is almost exclusively used in the pediatric population to assess for slipped upper femoral epiphysis (SUFE) and Perthes disease.The hip is the third most common joint affected by osteoarthritis after the knee and the hand 1. bilateral examination allows for better visualization of the hip joints and femoral neck.lataral projection to aid and diagnose femoroacetabular impingement (FAI) due to its increased sensitivity for detecting femoral head-neck asphericity.the ideal projection for bilateral hip or femur trauma.lateral projection demonstrating the neck of the femur without movement of the either limb.can only be conducted on unilateral hip trauma.lateral projection demonstrating the neck of the femur without movement of the affected limb.standard rolled lateral view demonstrating the femoral neck and acetabular rim can only be performed on non-trauma patients.often only performed in follow up studies.demonstrates the hip joint in the AP plane, with the limb internally rotated so the neck of the femur is in profile.
Hip radiographs are performed for a variety of indications including 1-3:
The series is requested for a myriad of reasons from trauma to atraumatic hip pain. The hip series is comprised of an anteroposterior (AP) and lateral radiograph of the hip joint.