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Anterior and posterior hip osteoarthritis: prevalence and potential value of CT compared to radiographs

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Abstract

Purpose

To determine the added value of computed tomography (CT) to identify severe hip osteoarthritis (OA).

Materials and methods

A retrospective query of all cases of hip or knee arthroplasty planning CTs between January 2018 and March 2022 was performed. Age, sex, and symptoms were collected from the medical record. CTs were evaluated for the degree of osteoarthritis and classified using an adapted Kellgren-Lawrence (KL) grading system in the anterior, posterior, superior, and superomedial hip. Frontal hip or pelvis radiographs within 1 year of the CT were also graded.

Results

There were 265 eligible hips in 178 subjects, age 66 ± 11 (range 31–93) years, with 85/178 (48%) males and 93/178 (52%) females, and 127/265 (48%) right and 138/265 (52%) left hips. The posterior hip joint was the most common location for grade 2/3 OA (20%), followed by superior hip joint (14%). Anterior or posterior grade 2/3 OA occurred concurrently with superior or superomedial grade 2/3 OA in 32/68 (47%) of hips. Grade 2/3 OA was detected on CT more commonly than on XR both in the superior (14 vs 8.6%, P = 0.0016) and superomedial (8.7 vs 4.8%, P = 0.016) hip joint.

Of the 71 symptomatic hips, 22 (31%) hips demonstrated either anterior and/or posterior grade 2/3 OA on CT, and 9 (9/22, 41%) of these hips had superior or superomedial grade 0/1 OA.

Conclusion

CT may be warranted when the patient has pain suggestive of osteoarthritis not detected on radiographs.

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Data Availability

Data is available upon request.

References

  1. Allen KD, Thoma LM, Golightly YM. Epidemiology of osteoarthritis. Osteoarthr Cartil. 2022;30(2):184–95. https://doi.org/10.1016/j.joca.2021.04.020.

    Article  CAS  Google Scholar 

  2. Üreten K, Arslan T, Gültekin KE, Demir AND, Özer HF, Bilgili Y. Detection of hip osteoarthritis by using plain pelvic radiographs with deep learning methods. Skelet Radiol. 2020;49(9):1369–74. https://doi.org/10.1007/s00256-020-03433-9.

    Article  Google Scholar 

  3. Barbara N, Weissman DNM. ACR Appropriateness Criteria® chronic hip pain. J Am Coll Radiol. 14(5):S90–S102. https://doi.org/10.1016/j.jacr.2017.01.035.

  4. von Schacky CE, Sohn JH, Liu F, et al. Development and validation of a multitask deep learning model for severity grading of hip osteoarthritis features on radiographs. Radiology. 2020;295(1):136–45. https://doi.org/10.1148/radiol.2020190925.

    Article  Google Scholar 

  5. Lewińska A, Palczewski P, Rongies W, Szczęsny G, Tomaszewski W. Advances in imaging of hip osteoarthritis. Ortop Traumatol Rehabil. 2019;21(1):1–14. https://doi.org/10.5604/01.3001.0013.0384.

    Article  PubMed  Google Scholar 

  6. Schafer P, Mehaidli A, Zekaj M, et al. Assessing knee anatomy using Makoplasty software a case series of 99 knees. J Orthop. 2020;20:347–51. https://doi.org/10.1016/j.jor.2020.05.023.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Mortensen AJ, Philippi MT, Karns MR, et al. A narrow posterior joint space on a false profile radiograph does not correlate with posterior joint cartilage degeneration in hip preservation patients. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2020;36(12):2984–91. https://doi.org/10.1016/j.arthro.2020.07.023.

    Article  Google Scholar 

  8. Kohn MD, Sassoon AA, Fernando ND. Classifications in brief: Kellgren-Lawrence classification of osteoarthritis. Clin Orthop Relat Res. 2016;474(8):1886–93. https://doi.org/10.1007/s11999-016-4732-4.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Bijlsma JWJ, Knahr K. Strategies for the prevention and management of osteoarthritis of the hip and knee. Best Pract Res Clin Rheumatol. 2007;21(1):59–76. https://doi.org/10.1016/j.berh.2006.08.013.

    Article  PubMed  CAS  Google Scholar 

  10. Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis. 1957;16(4):494–502. https://doi.org/10.1136/ard.16.4.494.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  11. Croft P, Cooper C, Wickham C, Coggon D. Defining osteoarthritis of the hip for epidemiologic studies. Am J Epidemiol. 1990;132(3):514–22. https://doi.org/10.1093/oxfordjournals.aje.a115687.

    Article  PubMed  CAS  Google Scholar 

  12. Katz JN, Arant KR, Loeser RF. Diagnosis and treatment of hip and knee osteoarthritis: a review. JAMA. 2021;325(6):568–78. https://doi.org/10.1001/jama.2020.22171.

    Article  PubMed Central  CAS  Google Scholar 

  13. Farr J, Covell DJ, Lattermann C. Cartilage lesions in patellofemoral dislocations: incidents/locations/when to treat. Sports Med Arthrosc Rev. 2012;20(3):181–6. https://doi.org/10.1097/JSA.0b013e318259bc40.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Jeong HK, An S, Herrin K, Scherpereel K, Young A, Inan OT. Quantifying asymmetry between medial and lateral compartment knee loading forces using acoustic emissions. IEEE Trans Biomed Eng. 2022;69(4):1541–51. https://doi.org/10.1109/TBME.2021.3124487.

    Article  PubMed  Google Scholar 

  15. Everhart JS, Abouljoud MM, Poland SG, Flanigan DC. Medial compartment defects progress at a more rapid rate than lateral cartilage defects in older adults with minimal to moderate knee osteoarthritis (OA): data from the OA initiative. Knee Surg Sports Traumatol Arthrosc. 2019;27(8):2401–9. https://doi.org/10.1007/s00167-018-5202-1.

    Article  PubMed  Google Scholar 

  16. Steppacher SD, Meier MK, Albers CE, Tannast M, Siebenrock KA. Acetabular cartilage thickness differs among cam, pincer, or mixed-type femoroacetabular impingement: a descriptive study using in vivo ultrasonic measurements during surgical hip dislocation. Cartilage. 2021;13(2_suppl):465S–75S. https://doi.org/10.1177/1947603521990879.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  17. Hasegawa K, Okamoto M, Hatsushikano S, et al. Standing sagittal alignment of the whole axial skeleton with reference to the gravity line in humans. J Anat. 2017;230(5):619–30. https://doi.org/10.1111/joa.12586.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Hara D, Nakashima Y, Hamai S, et al. Dynamic hip kinematics in patients with hip osteoarthritis during weight-bearing activities. Clin Biomech (Bristol, Avon). 2016;32:150–6. https://doi.org/10.1016/j.clinbiomech.2015.11.019.

    Article  PubMed  Google Scholar 

  19. Meyer CAG, Wesseling M, Corten K, et al. Hip movement pathomechanics of patients with hip osteoarthritis aim at reducing hip joint loading on the osteoarthritic side. Gait Posture. 2018;59:11–7. https://doi.org/10.1016/j.gaitpost.2017.09.020.

    Article  PubMed  Google Scholar 

  20. Kubota M, Shimada S, Kobayashi S, et al. Quantitative gait analysis of patients with bilateral hip osteoarthritis excluding the influence of walking speed. J Orthop Sci. 2007;12(5):451–7. https://doi.org/10.1007/s00776-007-1160-z.

    Article  PubMed  Google Scholar 

  21. Eitzen I, Fernandes L, Nordsletten L, Risberg MA. Sagittal plane gait characteristics in hip osteoarthritis patients with mild to moderate symptoms compared to healthy controls: a cross-sectional study. BMC Musculoskelet Disord. 2012;13:258. https://doi.org/10.1186/1471-2474-13-258.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Kerrigan DC, Lee LW, Collins JJ, Riley PO, Lipsitz LA. Reduced hip extension during walking: healthy elderly and fallers versus young adults. Arch Phys Med Rehabil. 2001;82(1):26–30. https://doi.org/10.1053/apmr.2001.18584.

    Article  PubMed  CAS  Google Scholar 

  23. Lee LW, Zavarei K, Evans J, Lelas JJ, Riley PO, Kerrigan DC. Reduced hip extension in the elderly: dynamic or postural? Arch Phys Med Rehabil. 2005;86(9):1851–4. https://doi.org/10.1016/j.apmr.2005.03.008.

    Article  PubMed  Google Scholar 

  24. Winter DA, Patla AE, Frank JS, Walt SE. Biomechanical walking pattern changes in the fit and healthy elderly. Phys Ther. 1990;70(6):340–7. https://doi.org/10.1093/ptj/70.6.340.

    Article  PubMed  CAS  Google Scholar 

  25. Cibulka M. Hip pain and mobility deficits—hip osteoarthritis. J Orthop Sport Phys Therapy. 2009;

  26. Cibulka MT, Threlkeld J. The early clinical diagnosis of osteoarthritis of the hip. J Orthop Sports Phys Ther. 2004;34(8):461–7. https://doi.org/10.2519/jospt.2004.34.8.461.

    Article  PubMed  Google Scholar 

  27. Gebre RK, Hirvasniemi J, van der Heijden RA, et al. Detecting hip osteoarthritis on clinical CT: a deep learning application based on 2-D summation images derived from CT. Osteoporos Int. 2022;33(2):355–65. https://doi.org/10.1007/s00198-021-06130-y.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, Yawkey 6E, 55 Fruit Street, Boston, MA, 02114, USA

    Ronald W. Mercer, Ukasha Habib, Juliana Xie, F. Joseph Simeone & Connie Y. Chang

  2. Department of Radiology, Sengkang General Hospital, East Way, Sengkang, 110, Singapore

    Cynthia Assimta Peter

  3. Department of Radiology, Brooke Army Medical Center, 3551 Roger Brooke Drive, Fort Sam Houston, TX, 78234, USA

    Adam Graeber

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  1. Ronald W. Mercer
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Correspondence to Connie Y. Chang.

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All procedures performed in studies involving human subjects were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the Human Research IRB (Protocol #: 2022P000685).

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The study was approved by the local Institutional Review Board (IRB) and HIPAA compliant. Verbal consent for participation in the study was obtained as per IRB protocol.”

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Mercer, R.W., Peter, C.A., Habib, U. et al. Anterior and posterior hip osteoarthritis: prevalence and potential value of CT compared to radiographs. Skeletal Radiol 53, 473–479 (2024). https://doi.org/10.1007/s00256-023-04434-0

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  • DOI: https://doi.org/10.1007/s00256-023-04434-0

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