![]() Figure 1 demonstrates an example of femoral collum osteophytes in US view, in CR views, and in THA image. Concerning the shape of the femoral head, slightly flattened appearance was observed in 46/68 (68%) and distinct deformity in 15/68 (22%) of the cases. In the anterior acetabulum, small osteophytes were seen in 32/68 (47%) and large osteophytes in 34/68 (50%) of the cases. In the femoral collum, small osteophytes were observed in 15/68 (22%) and large osteophytes in 51/68 (75%) of the cases. Osteoarthritic US findings were highly prevalent in this study population: Effusion (≥ 8 mm) was detected in 21/68 (31%) of the cases and the mean thickness was 7.2 mm (SD 2.7 mm, range 4 to 18 mm). The prevalence of US findings and inter-rater reliability Moreover, the inter-observer reliability of the hip US, and association between the US and Oxford Hip Score (OHS) were assessed. Thus, the objective of this study was to evaluate the US findings on patients with late-stage hip OA scheduled for THA, and to associate the US findings with radiographic and intraoperative findings. ![]() Although hip US offers a non-invasive, widely available, low-cost tool without radiation burden, the literature on hip OA is very scarce. The only original publication systematically describing US evaluation of hip OA is by Qvistgaard et al., who developed a scoring system for hip OA, assessed the reproducibility of hip US and the correlation to pain 10. In the hip joint, US can be used to determine the presence of osteophytes, synovial fluid/synovitis and to evaluate the morphology of the femoral head 10, 11, 12. For instance in the knee OA, US has been considered even to outperform CR 5, 6, 7, 8, 9. Ultrasonography (US) is an emerging modality in OA diagnostics. However, a poor association between the CR findings and clinical symptoms in hip OA exists 4. Currently, the diagnosis of hip OA consists of patient history, physical examination, and conventional radiography (CR) which is deemed as the primary imaging method of choice in OA. As the treatment of early-stage hip OA is mainly conservative, in late-stage when daily activity is severely compromised, the treatment of choice is THA. Additionally, approximately 10% lifetime risk of undergoing a total hip arthroplasty (THA) for late-stage hip OA exists 3. The estimated lifetime risk of symptomatic hip OA is 25% for people who live to age of 85 years 2. As the global life expectancy and the prevalence of obesity is rising, the amount of OA patients will rise in the future 1. Hip osteoarthritis (OA) causes significant morbidity, lowers the quality of life, and creates a considerable socioeconomic burden worldwide. ![]() The inter-rater reliability of the US evaluation varies from moderate to excellent, and no association between US and OHS was observed in this patient cohort. On femoral head deformity, performance of the US is superior to CR. US provides similar detection of osteophytes as does CR. For the femoral head deformity, they were 92%, 36%, 38% and 83%, and for the effusion 49%, 85%, 58% and 90%, respectively. Concerning acetabular osteophytes, the respective values were 96%, 0%, 88% and 91%. When THA findings were used as the gold standard, US detected femoral collum osteophytes with 95% sensitivity, 0% specificity, 81% accuracy, and 85% positive predictive value. The pooled inter-rater reliability ( n = 65) varied from moderate to excellent (k = 0.538–0.815). Osteoarthritic US findings were very common, but no association between the US findings and OHS was observed. The diagnostic performance of US and CR was compared by applying the THA findings as the gold standard. OA findings-osteophytes at femoral collum and anterosuperior acetabulum, femoral head deformity and effusion-were assessed on US, CR and THA. Mean patient age was 67.6 years and 38% were males. Sixty-eight hips were included, and intraoperative findings were available on 48 hips. Moreover, the inter-rater reliability of hip US, and association between the US and Oxford Hip Score (OHS) were evaluated. Aim of this study was to assess the US findings of patients with late-stage hip OA undergoing total hip arthroplasty (THA), and to associate the US findings with conventional radiography (CR) and intraoperative findings.
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