Abstract
ObjectiveTo estimate the prevalence of acetabular rim ossifications in the adult population with asymptomatic, morphologically normal hips at CT and to determine whether the presence of these ossifications is associated with patient- or hip-related parameters.MethodsWe prospectively included all patients undergoing thoracoabdominal CT over a 3-month period. After exclusion of patients with a clinical history of hip pathology and/or with signs of osteoarthritis on CT, we included a total of 150 hips from 75 patients. We analyzed the presence and the size of ossifications around the acetabular rim. The relationships between the size of acetabular rim ossifications and patient-related (sex, age, BMI) or hip-related parameters (joint space width, and cam- and pincer-type femoroacetabular impingement morphology) were tested using multiple regression analysis.ResultsThe prevalence of acetabular rim ossifications in this population of asymptomatic, non-osteoarthritic hips was 96% (95% CI = [80.1; 100.0]). The presence of ossifications and their size were correlated between the right and left hips (Spearman coefficient = 0.64 (95% CI = [0.46;0.79]), p < 0.05)). The size of acetabular rim ossifications was significantly associated with age (p < 0.0001) but not with BMI (p = 0.35), gender (p = 0.05), joint space width (p ≥ 0.53 for all locations), or any of the qualitative or quantitative parameters associated with femoroacetabular morphology (p ≥ 0.34).ConclusionAcetabular rim ossifications are highly prevalent in asymptomatic, non-osteoarthritic adult hips at all ages. Their size is not correlated with any patient- or hip-related parameters except for age. These findings suggest that ossifications at the acetabular rim, when present in isolation, should not be considered a sign of osteoarthritis or femoroacetabular impingement morphology.Key Points• Acetabular rim ossifications are extremely common in asymptomatic, non-osteoarthritic adult hips.• Acetabular rim ossifications are present independently from other signs of osteoarthritis in adult hips at all ages and should not be interpreted as a pathological finding.• The diagnosis of osteoarthritis or femoroacetabular impingement morphology should not be made based on the sole presence of ossifications at the acetabular rim.
Highlights
In clinical practice, ossifications adjoining the acetabular rim are frequently seen in otherwise healthy-appearing hip joints, at all ages
The diagnosis of osteoarthritis or femoroacetabular impingement morphology should not be made based on the sole presence of ossifications at the acetabular rim
Our main findings were that (1) the prevalence of acetabular rim ossifications (ARO) is high in asymptomatic hips with no imaging sign of osteoarthritis, (2) there is a right-left side association both for the presence of ARO and their size, (3) age is the only patientrelated parameter that is associated with ARO, and (4) there is no association of ARO with hip-related morphological parameters, including quantitative and qualitative parameters descriptive of femoroacetabular impingement (FAI) morphology
Summary
Ossifications adjoining the acetabular rim are frequently seen in otherwise healthy-appearing hip joints, at all ages. The origin of these acetabular rim ossifications (ARO) is unclear. While marginal osteophytes are classically found at this location, some authors have advocated that these ossifications may correspond to ossifications of the acetabular labrum, based on imaging and histological analyses [1,2,3,4,5]. While some authors believe that these ossifications correspond to an early stage of the formation of acetabular osteophytes, others describe a phenomenon distinct from osteophyte formation, either by endochondral ossification of the labrum or by appositional bone formation in the subperiosteal part of the acetabular rim, which displaces and replaces the labrum [1, 3, 6, 7]
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