4/8/2024 0 Comments Xray of normal hip jointSignificant arthritic bone changes along the femoral neck and head and acetabular rim changes. The ball is partly or completely out of a shallow socket. Severe: Marked evidence that hip dysplasia exists.There are secondary arthritic bone changes usually along the femoral neck and head (remodeling), acetabular rim changes (osteophytes or bone spurs) and various degrees of trabecular bone pattern changes Moderate: The ball is barely seated into a shallow socket.The socket is usually shallow only partially covering the ball. Mild: Significant subluxation present where the ball is partially out of the socket causing an increased joint space.Usually more incongruency present than what occurs in a fair but there are no arthritic changes present that definitively diagnose the hip joint being dysplastic. The socket may also appear slightly shallow. The ball slips slightly out of the socket. Fair: Minor irregularities the hip joint is wider than a good hip.The ball fits well into the socket and good coverage is present. Good: Slightly less than superior but a well-formed congruent hip joint is visualized.Excellent: Superior conformation there is a deep-seated ball (femoral head) that fits tightly into a well-formed socket(acetabulum) with minimal joint space."Given these findings, patients with suspected hip OA should be treated regardless of x-ray confirmation.The OFA classifies hips into seven different categories: Excellent, Good, Fair (all within Normal limits), Borderline, and then Mild, Moderate, or Severe (the last three considered Dysplastic). According to Kim, up to 10 percent of patients with OA do not meet adequate physical activity recommendations, and are associated with having higher risk of developing heart or lung disease, diabetes, obesity and falls. Missing the diagnosis of hip OA has consequences. "The majority of older subjects with high suspicion for clinical hip osteoarthritis did not have radiographic hip osteoarthritis, suggesting that many older persons with hip osteoarthritis might be missed if diagnosticians relied on hip radiographs to determine if hip pain was due to osteoarthritis," explained corresponding author Chan Kim, MD, instructor of medicine at Boston University School of Medicine. In both study populations, hip pain was not present in many patients with radiographic OA, and many with hip pain did not have imaging evidence of hip OA. Results of the Osteoarthritis Initiative were similar with nine percent and 24 percent, respectively. In the Framingham study, only 16 percent of patients with hip pain had radiographic hip OA, and only 21 percent of hips with radiographic OA had hip pain. Researchers looked at the Framingham Osteoarthritis and Osteoarthritis Initiative studies, with nearly 4,500 participants. The population of people over age 60 has more than doubled in the past 30 years, and the total cost of OA (both treatment and complications) amount to $185.5 billion annually and is expected to rise exponentially. ![]() More than 330,000 hip replacements are performed in the U.S. Hip osteoarthritis (OA) is a significant source of morbidity causing pain, difficulty walking, and disability. The study appears in the British Medical Journal. These findings are the first to evaluate the diagnostic performance of an x-ray in patients with clinical signs and symptoms of classic OA.
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