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Hip osteoarthritis is not always apparent on an x-ray, and new research suggests that x-rays are not a reliable way of diagnosing the condition in the majority of cases.
In a study published in the British Medical Journal, researchers evaluated the diagnostic performance of an x-ray in patients with clinical signs and symptoms of classic OA.
They assessed data from the Framingham Osteoarthritis and Osteoarthritis Initiative studies, which involved nearly 4,500 participants. In the Framingham study, only 16% of patients with hip pain had osteoarthritis that could be detected through radiographic scans, while only 21% of hips with radiographic OA had hip pain. Results of the Osteoarthritis Initiative were similar, with 9% and 24% respectively.
The researchers noted that, 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.
Is Hip Arthritis The Cause Of My Pain
Hip arthritis is typically felt in the groin area. That’s because the actual hip joint is a ball-and-socket between your pelvis and your thigh bone.
It’s NOT the bump on the outside of your hip like many people think it is.
The bump on the outside of your hip is just a place for muscles to attach to move your thigh bone. It’s actually not a joint at all.
This means that true hip arthritis is typically felt in the groin region, where the joint is actually located. The pain may radiate down the inner thigh.
People with hip arthritis MAY also have pain in the buttock or pain on the outside of the hip, but these are usually secondary to muscle imbalances – often the same muscle imbalances that caused the hip arthritis in the first place!
So if you have hip arthritis on your x-rays and you DON’T have groin pain, chances are good that you won’t need a hip replacement.
What About Pain In The Back Of The Hip
Pain in the back of the hip is most commonly a referred pain from your lower back.
Both the joints in your lower back as well as the L5 and S1 nerve roots refer pain to the buttock. Additionally, some of the muscles in your lower back refer pain to the buttock.
If you have pain in back of the hip, I would probably assume it’s coming from your lower back unless proven otherwise.
However your sciatic nerve or trigger points in your buttock or hamstring muscles can also cause pain in the buttock.
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Classification Systems Of Hip Osteoarthritis
Hip OA can be classified according to its etiology, time of onset, severity, and clinical course. In primary hip OA, cartilage degradation can either be idiopathic or develop in association with dynamic conflict between the articular surfaces, the FAI syndrome . In secondary hip OA, joint degradation results from preexisting conditions including developmental hip dysplasia, growth-associated disorders, fracture, femoral head osteonecrosis and inflammatory or metabolic synovial disorders . Early-onset and late-onset disease develop either before or after 50 years of age . Early-stage and late-stage OA differ according to the absence or presence of radiological structural changes with a joint space width of more or less than 2 mm on AP pelvic radiographs . The clinical course of hip OA is usually slow and pain fluctuates over the years with no or minor radiological changes over time . Rapidly destructive hip OA is uncommon and is defined by the development of complete loss of radiological JSW or severe bone attrition on CR within 12 months after symptoms onset . All these classification systems and threshold values are open for discussion, but they rely on good clinical practice standards for which preservative hip surgery should not be performed after 50 years of age or when the radiological JSW is< 2 mm.
Fig. 1
Dog Arthritis What Is It
Im sure youve heard of arthritis in humans the inflammation of joints that make for an uncomfortable experience in everyday living. Did you know dogs are just as susceptible to arthritis as well? In fact, one in five dogs will experience arthritis in their lifetime. Most often affecting senior dogs, this degenerative joint disease takes many forms however, the most common type of arthritis in dogs is osteoarthritis. Osteoarthritis is arthritis affecting multiple joints the pain and discomfort felt as a result of arthritis is disruptive to daily life. In most cases of osteoarthritis, the cause of pain is the constant and abnormal rubbing within the joints due to joint instability.
In addition to osteoarthritis, other types of inflammatory joint disease in dogs can be caused by a number of factors, including: diabetes, bacterial or fungal infections, osteochondrosis, old injuries, increased activity levels in working dogs, obesity, and Cushings disease. The most common joint areas affected by arthritis in dogs are the hips, elbows, lower back, knees, and wrists.
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Is There A Special Preparation Needed For An X
There is no special preparation required for an arthritis X-Ray. The only people who should consider are the pregnant women. The pregnant women must inform the technician about their pregnancy because the exposure to radiation may cause harm to the fetus, so it must be minimized.
At the time of X-Ray, a person should take off their jewelry before taking a test. There could be a requirement to remove some clothes, depending on the body parts to be tested. The technician will provide some something to cover the body part.
*All individuals are unique. Your results can and will vary.
If You Have Osteoporosis Is There A Risk Of The Bone Shattering Or Breaking During The Surgery
Unfortunately, breaking bones is always a risk, regardless of if you have osteoporosis. All surgeons do techniques to minimize the risk of a fracture during surgery. The weaker your bone, the higher the risk, so for older patients or patients with severe osteoporosis a different type of hip implant is used. Regular implants are wedged into place, but this implant is instead glued into place with special bone cement.
Recommended Reading: Exercising With Arthritis In The Hip
How To Ease The Pain
There is no cure for osteoarthritis, but there are a number of things you can do to relieve the symptoms.
The main treatments include lifestyle measures such as maintaining a healthy weight and exercising on a regular basis.
This is because it can help build up muscle and strengthen the joints, the NHS states.
Keeping a healthy diet and losing weight if you’re overweight will also help, guidance states.
This is because the extra weight places pressure on your joints.
Home Remedies For Arthritis
In addition to treatments recommended by your doctor, you can use dry heat from a heating pad or moist heat in the form of a hot bath or a hot-water bottle wrapped in a towel to help relieve pain and stiffness. Heat and rest are very effective in the short run for most people with the disease. Regular exercise is also important to keep the joints mobile.
If you are overweight, losing weight is key, especially when arthritis affects the lower back, knees, and legs. Extra pounds add to the load and pressure on your joints, which can cause your arthritis to get worse faster. Being overweight also raises your chances of related health problems. Consult a registered dietitian who can help you plan a healthy weight loss program.
People with weakened, badly deformed fingers from rheumatoid arthritis benefit from specially designed utensils and door and drawer handles people with weakness in the legs and arms can use special bathroom fixtures, especially tub rails and elevated toilet seats.
Although arthritis may not be preventable, disability is — with a well-designed treatment program, including medications, exercise, and physical therapy when needed.
Here are some more things you can do to help keep the condition in check:
Educate yourself. Take a self-management course to learn specifics on day-to-day arthritis care.
Get active. Exercise can help you move better, lessen pain, and put off disability.
Read Also: Why Does My Hip Hurt At Night
What Causes Osteoarthritis
The most common form of arthritis, osteoarthritis, is associated with injuries, wear-and-tear processes, and genetics. An arthritis joint will demonstrate the narrow bone spaces due to various reasons. The cartilage thins, the formation of cysts within bones, bones spurs seen on the edges, deformity of joints are some of the reasons, which leads to crooked joints.
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Strengths Of This Study
Our study has important strengths. The Framingham Osteoarthritis Study was community based and recruitment of participants was without reference to joint problems. Although participants in the Osteoarthritis Initiative were originally recruited for a longitudinal study of knee osteoarthritis, the findings in this cohort replicated the similarly poor concordance between hip pain and radiographic hip osteoarthritis seen in the Framingham Osteoarthritis Study. The validity of our findings is suggested by the strong association of prevalence of hip osteoarthritis with age.1 We found that women had a higher prevalence of hip pain than men in both the Framingham Osteoarthritis Study and the Osteoarthritis Initiative, and this is consistent with other studies.14373839
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Can You Detect Arthritis In An X Ray
The above image is the X-Ray image of knee arthritis, which is a very common form of osteoarthritis among the older groups of people. According to the study, around 10% male and 13% female over the age of 60 are diagnosed with knee osteoarthritis. We can see how the knee of the patients suffering from arthritis is different from the knee of a normal person.
What Happens During A Hip X
Your hip X-ray will be performed by a radiologic technologist in your healthcare providers office or a hospital radiology department. The X-ray room will contain a table with an X-ray machine suspended from the ceiling. Once in the X-ray room, your technologist may give you a lead apron to wear to protect you from radiation exposure. An X-ray is like getting a picture of your hip taken you cant feel it, and it creates an image. The procedure may take 10 minutes or more.
Your technologist will place a digital recording plate under the X-ray table. Theyll have you lie down on your back on the table. Youll need to keep very still during the procedure. Any movement can cause the X-ray images to show up blurry. The technologist may ask you to hold your breath while theyre taking the images.
Your technologist will go into a small room or behind a wall to operate the X-ray machine. Theyll return to reposition you for additional images.
A normal hip X-ray includes at least two different images. Your technologist will take one image with your legs straight and one image with your knees apart and feet together .
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Basics Of Hip Arthritis
Many kinds of arthritis can affect the hip joint. The most common type of hip arthritis is osteoarthritis, which some people call “degenerative joint disease.”
Osteoarthritis occurs when the joint surface cartilage becomes worn away leaving the raw bone beneath exposed. The cartilage normally serves as a pad or a bearing in the joint. Under normal conditions, the cartilage bearing is slicker than a hockey puck on ice. When the bearing wears away, the result is a roughed joint surface that causes the pain and stiffness that people associate with osteoarthritis .
Osteoarthritis of the hip is a serious condition. Osteoarthritis is the most common of the more than 100 kinds of arthritis and the hip joint is the second most commonly affected large joint in the body.
Osteoarthritis is a chronic disease that can takes months to years to appear. While it is not curable, it most certainly is treatable using activity modifications, medications, and/or injections. If those interventions dont work, hip replacement surgery often will relieve the pain associated with hip arthritis.
Osteoarthritis of the hip results in pain, stiffness, and joint deformity. The symptoms of osteoarthritis can affect ones ability to walk, work, and enjoy life.
For most patients who have mild arthritis, pain can be managed with ice, rest, activity modifications, pills, or joint injections.
Mobility / Flexibility Exercises For Hip Arthritis
The goal of these these hip arthritis exercises is to maximize the space available in the hip joint.
With today’s technology, it’s not currently possible to regenerate cartilage within the hip joint, but you can do things to make the most of the joint space that you DO have available.
One great example of a mobility exercise is pulling your knee towards your chest either while sitting or laying down.
The goal of this exercise is to stretch the back part of the hip.
If you feel a pain or pinching in the front of the hip or groin when doing this, it’s OK to go just up to the point of pain, but don’t try to push past it.
This is NOT a no pain, no gain type of stretch.
If you’re getting pinching in the groin when doing this exercise, you’ve likely reached the end range of the hip joint, and you’re just going to jam the ball and socket together further if you try to push it.
It won’t feel good, and it won’t help your problem. If anything, it will just make you more sore.
Read Also: Stretches For Lower Back Pain And Hips
Complications Of Surgery For Hip Arthritis
- Allergic reaction: You may have an allergy to the anaesthetic used. You may feel sick for a short time.
- Infection: To reduce this risk you will be given antibiotics for the first 24 hours after surgery.
- Blood clots: The risk of developing a clot is low, around 1-4%. There are well-established treatments available to resolve them should they occur, including aspirin.
- Pain: This can usually be effectively managed with painkillers, and you will be prescribed pain medication after your surgery.
Arthroscopic hip surgery and total hip replacement surgery are common procedures, but there are some specific complications of any type of hip surgery to be aware of:
- Loosening and wear of the artificial hip prosthesis: Just as regular joints suffer wear and tear, so too do artificial joints. Although this is often a big concern of many patients before surgery, a hip replacement can usually be expected to last for 10 years or more.
- Stiffness: You should expect the hip to have some stiffness after the operation. This will improve over time with physiotherapy and as your hip recovers from the surgery.
- Nerve damage: Damage to nerves around the hip can lead to some weakness, numbness or pain in the leg or foot. This usually settles on its own but may be permanent. It is very rare.
- Lump under the wound: Sometimes, you may develop a lump under the wound after hip surgery. This is caused by a small amount of bleeding under the skin and usually settles after a few weeks.
Citation Doi & Article Data
Citation:DOI:Paresh K DesaiRevisions:see full revision historySystem:
- Degenerative joint disease of the hip
- Osteoarthritis of the hip
Osteoarthritis of the hip can be graded according to its severity.
Classification
Different grading schemes are described for plain radiographs of the hip:
- grade 0: normal
- grade 1: possible joint space narrowing and subtle osteophytes
- grade 2: definite joint space narrowing, defined osteophytes and some sclerosis, especially in the acetabular region
- grade 3: marked joint space narrowing, small osteophytes, some sclerosis and cyst formation and deformity of femoral head and acetabulum
- grade 4: gross loss of joint space with above features plus large osteophytes and increased deformity of the femoral head and acetabulum
Tönnis classification for osteoarthritis of the hip
The original Tönnis classification consists of three degrees of degenerative changes featuring osteoarthritis of the hip. Grade 0 was added later 2,3.
- grade 0: no signs of osteoarthritis
- grade 1: minor joint space narrowing, subchondral sclerosis of the femoral head and/or acetabulum, small osteophytes
- grade 2: moderate joint space narrowing,small subchondral cysts of the femoral head and/or acetabulum, moderate loss of sphericity of the femoral head
- grade 3: severe joint space narrowing or obliteration, large subchondral cysts, severe deformity of the femoral head
Croft score for hip osteoarthritis
MRI
See also
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Surgical Treatments For Hip Arthritis
Your doctor will discuss the different surgical procedures with you and determine which one will be of most benefit for your condition. One of the most common procedures to treat severe hip arthritis is a total hip replacement:
Should arthritis in your hip joint develop to the point you are in constant discomfort and have extremely limited movement, a total hip replacement may be advised as the best treatment for you.
With very little pain and a short recovery period, hip replacement surgery is life-changing for many people. It can restore the freedom to move freely, exercise or even just walk to the shops, all pain-free.
During total hip replacement surgery, the damaged and worn bones of the hip joint are replaced with a cobalt/chrome metal joint.
This new artificial hip joint removes the problems caused by the worn articular cartilage of osteoarthritis and is designed to provide friction-free movement. This improves the mobility of the joint, while also helping to reduce the pain and stiffness in the hip joint.