Hip pain related to definite and early-stage radiographic hip Osteoarthritis

A recent study found that there was a modest prevalence of early-stage hip radiographic osteoarthritis in patients complaining of hip pain. This can be used to diagnose patients with hip osteoarthritis who complain of hip or knee pain. The study was published in the British Journal of General Practice.  

Hip osteoarthritis is a common cause of morbidity among geriatric patients associated with pain and stiffness. Clinical symptoms like pain and stiffness associated with radiographic features help in the diagnosis of hip osteoarthritis. But there is uncertainty in the association between hip pain and hip radiographic OA (ROA). Hence researchers from MC University Medical center, Rotterdam conducted a cross-sectional analysis of a Dutch cohort called the Cohort Hip and Cohort Knee (CHECK) study to examine the association between hip pain and hip ROA. 

All the participants aged 45–65 years, who had experienced hip and/or knee pain without prior consultation or were within 6 months of their first consultation were included in the study. ROA was taken using weight-bearing anteroposterior pelvis radiographs. Definite and early-stage hip ROA was defined as Kellgren and Lawrence grade ≥2 and ≥1, respectively. The presence of ROA and pain was assessed in the hips of all participants. Generalized estimating equations were used to establish an association between hip pain and ROA. 

Results:

• The prevalence of definite ROA was 11.0% (n = 218/1982 hips). 
• Prevalence of early-stage hip ROA was 35.3% (n = 700/1982). 

• Compared with pain-free hips, the odds ratio of painful hips was 1.51 for definite ROA and 1.47 for early-stage ROA. 

Thus, this study showed that Hip pain was associated with definite and early-stage hip ROA. But the overall ROA prevalence was modest and the prevalence among pain-free hips was substantial. 

Further reading: Rondas GA, Macri EM, Oei EH, Bierma-Zeinstra SM, Rijkels-Otters HB, Runhaar J. Association between hip pain and radiographic hip osteoarthritis in primary care: the CHECK cohort. Br J Gen Pract. 2022 Jul 26:BJGP.2021.0547. doi:10.3399/BJGP.2021.0547.