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Arthritis in hips

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Hi
can someone take a look at my hip xray at www.dickonclark.co.uk/xray.html and give me some advice. Doctor says " moderate arthritic change" but its not his field, any detail would be appreciated
Thanks
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First Helper User Profile Gaelic
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replied January 17th, 2012
Especially eHealthy
Kaminga,

You definitely have at least moderate degenerative changes in the hip joints.

You have osteophyte formation (bone spurs), subchondral sclerosis (the bone under the cartilage is dense), subchondral cyst formation (in the right acetabulum [socket] you have some cysts under the joint cartilage), and narrowing of the joint space (which is a indirect measure of cartilage wear). These are the four signs of degenerative joint disease and you have all four.

However, the left hip in this x-ray, shows a femoral head that is out of round. But, the right hip shows subchondral cyst formation and more narrowing of the joint space.

So, depending upon your symptoms, age, occupation, etc, you could be a candidate for total hip replacement. Of course, you would need to be evaluated by an orthopedic surgeon, and conservative measures would be tried first.

But, if you are significantly limited by your hip pain, you should see an orthopedic surgeon.

Good luck.
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replied January 18th, 2012
Thank you for your reply. Can you see from the xray why the right hand hip is giving me all the pain and virtually no pain on the left?
Thanks
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replied January 18th, 2012
Especially eHealthy
Kaminga,

You have very significant degenerative changes in the right hip joint. You have all four signs of degenerative joint disease in that joint.

It is not really known why some patients have more pain in one joint than another, when both joints have changes on x-ray. Of course, you cannot actually see the articular cartilage on x-ray. The articular cartilage is the smooth white covering on the ends of the bones, that form joints.

When you have degenerative joint disease, the articular cartilage becomes worn and damaged. Though the articular cartilage does not have any nerve endings itself, the bone under the cartilage does.

In your right hip you have subchondral sclerosis of the acetabular dome (socket). This is from wear and tear over time, causing the bone to become denser than normal (called sclerotic). You also have some subchondral cysts in the medial wall of the acetabulum. Cysts are little holes in the bone, that are believed to be caused by the wear and tear debris from the articular cartilage. You also have bone spurs off the upper and lower acetabulum and femoral heal (ball of joint). And, you also have the last sign, which is narrowing of the joint space.

There really isn't any space in the joint. It is actually where the cartilage is, it just doesn't show up on x-ray. So, the distance between the femoral head and acetabulum is called the joint space. If this distance is decreased, it is an indirect method of telling that the cartilage is wearing thin.


So, again, you have significant DJD (also called osteoarthritis) in both hips. The left one actually shows a femoral head that is not round, like it should be. So, if you were to just go on the basis of the x-rays, an orthopedic surgeon would probably say that the left hip was the worst. Again, it is not really known why one joint will hurt more than another, when the x-rays would predict the opposite.


If the pain in your hip is bothering you significantly, you should see an orthopedic surgeon for a thorough evaluation. There are some things that can be tried before jumping to surgery. But, if these all fail to help significantly, you would probably be a candidate for a total hip replacement.

Good luck.
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replied January 19th, 2012
Hi Gaelic
Thanks for your reply. I am 54 years old and spent many years jogging when younger.
Maybe thats the cause. Got an appointment with a physio on Wednesday and would like to show her your comments. Is it cheeky to ask you what your qualifications are? She may ask.
Thanks again
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replied January 19th, 2012
Especially eHealthy
Kaminga,

Check your private messages.

As to the jogging causing osteoarthritis, the evidence basically shows that a patient's increased activity level usually does not cause DJD.

It is actually more herditary.

Of course, if you injured your joints sometime in the past, that can cause traumatic degenerative changes in the joints.

There are patients who run and do manual labor their whole lives, and never develop DJD. Then, you have some patients who have been sedentary and had desk jobs, but they develop very severe degenerative changes. So, the research and evidence has not shown any correlation between activity and development of osteoarthritis (DJD - degenerative joint disease).

Often, patients with significant DJD have parents, grandparent, or siblings with the same problem. It does seem to run in families.

Good luck.
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Users who thank Gaelic for this post: victor007