Abstract
ObjectiveIt remains unclear how the different features of radiographic hip osteoarthritis (rHOA) contribute to hip pain. We examined the relationship between rHOA, including its individual components, and hip pain using a novel dual-energy x-ray absorptiometry (DXA)-based method.MethodsHip DXAs were obtained from UK Biobank. A novel automated method obtained minimum joint space width (mJSW) from points placed around the femoral head and acetabulum. Osteophyte areas at the lateral acetabulum, superior and inferior femoral head were derived manually. Semi-quantitative measures of osteophytes and joint space narrowing (JSN) were combined to define rHOA. Logistic regression was used to examine the relationships between these variables and hip pain, obtained via questionnaires.Results6807 hip DXAs were examined. rHOA was present in 353 (5.2%) individuals and was associated with hip pain [OR 2.42 (1.78–3.29)] and hospital diagnosed OA [6.01 (2.98–12.16)]. Total osteophyte area but not mJSW was associated with hip pain in mutually adjusted models [1.31 (1.23–1.39), 0.95 (0.87–1.04) respectively]. On the other hand, JSN as a categorical variable showed weak associations between grade ≥ 1 and grade ≥ 2 JSN with hip pain [1.30 (1.06–1.60), 1.80 (1.34–2.42) respectively]. Acetabular, superior and inferior femoral osteophyte areas were all independently associated with hip pain [1.13 (1.06–1.20), 1.13 (1.05–1.24), 1.10 (1.03–1.17) respectively].ConclusionIn this cohort, the relationship between rHOA and prevalent hip pain was explained by 2-dimensional osteophyte area, but not by the apparent mJSW. Osteophytes at different locations showed important, potentially independent, associations with hip pain, possibly reflecting the contribution of distinct biomechanical pathways.
Highlights
Osteoarthritis (OA) is a common condition with important sequelae in terms of morbidity and mortality, predominantly affecting knees, hands, spine and hip joints [1,2]
In a large (n = 6807) cross-sectional study of both men and women, we have developed and applied a method for performing detailed phe notyping of radiographic hip osteoarthritis (rHOA) based on high resolution dual-energy x-ray absorptiometry (DXA) scans
Those with rHOA as defined by DXA were associated with a higher prevalence of self-reported and hospital-diagnosed OA
Summary
Osteoarthritis (OA) is a common condition with important sequelae in terms of morbidity and mortality, predominantly affecting knees, hands, spine and hip joints [1,2]. Hip OA (HOA) can be defined radio graphically (rHOA) using classification systems such as KellgrenLawrence (KL) or Croft [3,4]. RHOA is usually studied as a categorical variable (0–4 for KL scoring (3) or 0–5. Croft scoring [4]) with a threshold defined for the presence of rHOA. HOA can be defined symptomatically (sHOA) [7,8]. Previous studies have examined the relationship between individual features of rHOA and hip pain, for example JSW was found to be only weakly associated with symptomatic measures of HOA [12].
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