X-Rays May Result in Failure To Diagnose Hip Arthritis: Study

The findings of a new study suggest that relying on X-rays alone may increase the risk that a doctor may fail to diagnose hip arthritis. 

Researchers from Boston University’s School of Medicine said that most older patients who were diagnosed with hip osteoarthritis (OA) did not have signs that showed up on x-rays, according to findings published this month in the medical journal The BMJ.

The study indicates that in many cases, patients with hip pain do not show signs of hip arthritis in radiographic images, while many x-rays that showed hip osteoarthritis were associated with patients who do not report suffering hip pain.

The research involved data from the Framingham Osteoarthritis and Osteoarthritis Initiative studies, which includes nearly 4,500 participants. Only 16% of those involved who reported hip pain had x-rays that indicated hip arthritis, while just 21% of patients who had x-rays indicating osteoathritis of the hip reported suffering pain. For those participating in the Osteoarthritis Initiative study, only nine percent who reported hip pain had an x-ray that indicated arthritis of the hip, while just 24% with x-rays indicating the condition was present reported hip pain.

“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,” Dr. Chan Kim, one of the study’s authors, said in a Boston University press release. “Given these findings, patients with suspected hip OA should be treated regardless of x-ray confirmation.”

Kim said 10% of patients with hip osteoarthritis engage in less physical activity due to pain, leading to a higher risk of heart and lung disease, diabetes, obesity and falls, making proper diagnosis and treatment important for their overall health.

Researchers estimate that hip osteoarthritis costs the healthcare system $185.5 billion per year; a number that is expected to rise exponentially as baby boomers continue to age. That cost includes treatment, complications, and more than 330,000 hip replacements per year.