Images should be acquired in coronal sagittal and oblique axial planes 10. In addition to the 3D visualization of acetabular and femoral head-neck morphology, MRI allows the assessment and semi-quantitative evaluation of a large variety of tissue abnormalities not only of the articular cartilage and/or the acetabular labrum but also of the bone marrow, the ligaments and the synovium 10,18-23. CTĬomputed tomography provides information on the 3D assessment of acetabular and proximal femoral anatomy and can be used for surgical planning in cases of femoroacetabular impingement (FAI) or acetabular dysplasia 18,19 or to assess the amount of bone stock 19. In addition, it can be used for image-guided injections 18. Ultrasound can depict joint effusions and synovitis by increased synovial vascularization and can detect osteophytes. Recommended scoring systems are the Kellgren and Lawrence score and the OARSI atlas 10. The radiological classification systems that are used for the assessment of osteoarthritis of the hip, the Kellgren and Lawrence score 14, the Croft score 15 and the Tönnis classification are all susceptible to subjectivity, but the first is apparently the most reliable 10,16.Īnother semi-quantitative method, which does not give a definition of osteoarthritis by grade, but grades different features of osteoarthritis as femoral and acetabular osteophyte formation as well as superior and medial joint space narrowing is the OARSI atlas 10,17. The minimal joint space width is measured between the femoral head and the nearest part of the acetabular sourcil (representing the weight-bearing surface) 29. 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.

The hip is the third most common joint affected by osteoarthritis after the knee and the hand 1.

Xray of a normal hip joint