5/15/2023 0 Comments Hip xray normalThe roof limits are the lateral extremity of the condensed subchondral bone and, medially, the junction roof-acetabular fossa line (fig 1 ⇑). JSW of the hip on the coronal radiograph refers to the interbone area between the acetabular roof and the part of the femoral head facing it. Furthermore, we examined the shape of the acetabular roof according to the three types noted by one of us over many years (see definitions below).įor the purposes of this study, the parameters used are defined as follows: The aims were not only to measure the JSW of normal hips at the three principal sites (fig 1 ⇓), and to determine the influence of age and sex, but also to check the possible relationship between JSW and primary architectural deformities (dysplasia, acetabular protrusion, and coxa profunda). Our study was sponsored by GETROA, a French research group comprising radiologists, rheumatologists, and orthopaedic surgeons, and involved 10 centres in France and one in Belgium (see Acknowledgements). In contrast, we found no studies considering the relationship between JSW and dysplasia, acetabular protrusion, or coxa profunda, or the distortion of the JS shape by possible acetabular roof dysmorphia. All these studies sought differences in JSW according to age and sex. The other three studies used pelvic x ray findings and involved 120, 11 240, 12 and 171 8 subjects. These radiographic incidences do not encompass exactly the same JS segment as routine radiographs of the pelvis, which are centred at a lower point. Two comprised 533 x ray studies 9 and 118 x ray studies 10 on plain urographic and abdominal films, respectively. We found five main published studies offering sufficient methodological details and dealing with the JSW of normal hips. Moreover, owing to a lack of accepted normal values, the JSW of interest is usually compared with the contralateral JSW, which may itself be abnormal. 2, 3 However, in studies of occupational risk, for example, the threshold JS value defining OA of the hip varies among authors from <4 to <1.5 mm, 4–, 7 and measurements are generally made only at the apical site. 1 As epidemiological studies include many painless OA hips, they often include JSN as the most robust and useful radiographic feature. The American College of Rheumatology classifies as “OA” only painful hips meeting at least two of the following three criteria: sedimentation rate ⩽20 mm/1st h, osteophyte, and joint space narrowing (JSN). These normal values are needed to set the limits of significant early radiographic alterations in patients with osteoarthritis (OA). More information is needed on the radiographic joint space (JS) of the normal hip, including its shape, its width at precise locations, and the influence of age, sex, and congenital morphology. These findings may have important implications for epidemiological studies and early diagnosis of osteoarthritis of the hip. The roof curve is dysmorphic in about 20% of patients. A roof curve abnormality was found in 96/446 (21.5%) hips.Ĭonclusions: Normal JSW values vary widely the JSW is commonly narrower at the superomedial site than at the apical site, and is sometimes asymmetric. The JSW was thicker in dysplastic hips, and thinner in hips with coxa profunda. Eight cases of acetabular dysplasia (7 unilateral) and 16 cases of coxa profunda were found, but no cases of acetabular protrusion. Marked right/left JSW asymmetry was seen in 13/221 (5.9%) subjects. Mean JSW values were higher at the superolateral site than at the apical and superomedial sites in nearly 80% of cases. Interindividual variations in JSW were large (apical site: 4.19 (0.92) mm range 2–7). Results: 223 radiographs (446 hips) from 127 women and 96 men (mean age 51.3 years) were examined. Methods: On routine conventional pelvic radiographs taken in the supine position in patients with no history of hip or lumbar pain, JSW was measured at three points (superolateral, apical, superomedial), together with the VCE, HTE, and neck shaft angles acetabular depth and femoral head diameter. Objectives: To determine the range of normal radiographic joint space width (JSW) values and the shape of the normal hip, and the influence of age, sex, dysplasia, coxa profunda, and acetabular roof curve abnormalities on these values.
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