CLINICAL AND RADIOGRAPHIC FEATURES OF PATIENTS WITH PRIMARY HIP OSTEOARTHRITIS ACCORDING TO ACR (1991) CRITERIA

Nguyen Thi Tra1, Nguyen Vinh Ngoc1, Bui Thi Huong1, Nguyen Ngoc Bich1, Pham Thi Mai Quyen1
1 Hanoi Medical University

Main Article Content

Abstract

Objective: To describe clinical and radiographic features in patients with primary hip osteoarthritis according to ACR (1991) criteria and to analyze associations between clinical features and radiographic findings.


Method: Cross-sectional descriptive study of 45 patients (51 hip joints) diagnosed with primary hip osteoarthritis per ACR (1991) criteria at Rheumatology Center of Bach Mai Hospital (July 2024 to August 2025).


Results: Most common clinical features were: hip pain during walking (98.0%); functional limitation (60.8%); morning stiffness under 30 minutes (39.2%); pain with hip movement (84.3%); reduced range of flexion, internal rotation, and hip abduction (52.9%). Hip radiographic features: acetabular osteophytes (86.2%); femoral osteophytes (74.5%); subchondral sclerosis (76.5%); joint-space narrowing (58.8%); femoral head deformity (25.5%). The prevalence of Kellgren-Lawrence grades 3-4 was 58.8%. Patients with radiographic hip joint-space narrowing had higher odds of severe pain (VAS ≥ 5) than those without narrowing (OR = 12.8). Compared with Kellgren-Lawrence grades 1-2, those with Kellgren-Lawrence grades 3-4 had much higher odds of functional limitation and decreased range of motion 84 times and 130 times, respectively.


Conclusion: Conventional hip X-ray has diagnostic value in determining and classifying the stage of hip osteoarthritis.

Article Details

References

[1] Lawrence R.C, Felson D.T, Helmick C.G et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States, part II.Arthritis Rheum, 2008, 58 (1): 26-35. https://doi.org/10.1002/art.23176.
[2] Murphy L.B, Helmick C.G, Schwartz T.A et al. One
in four people may develop symptomatic hip osteoarthritis in his or her lifetime. OsteoarthritisCartilage, 2010, 18 (11): 1372-1379. https://doi.org/10.1016/j.joca.2010.08.005.
[3] Altman R, Alarcón G, Appelrouth D et al. The
American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hip. Arthritis & Rheumatism, 1991, 34 (5): 505-514. https://doi.org/10.1002/art.1780340502.
[4] Jawetz S.T, Fox M.G et al (Expert Panel on Musculoskeletal Imaging). ACR appropriateness criteria® chronic hip pain: 2022 update. J Am Coll Radiol,2023, 20 (5S): S33-S48. https://doi.org/10.1016/j.jacr.2023.02.019.
[5] Lane N.E. Clinical practice. Osteoarthritis of the hip. N Engl J Med, 2007, 357 (14): 1413-1421.ps://doi.org/10.1056/nejmcp071112.
[6] Lin D.C.M, Reichmann W.M, Gossec L, Losina E,Conaghan P.G, Maillefert J.F. Validity and responsiveness of radiographic joint space width metricmeasurement in hip osteoarthritis: a systematic review. Osteoarthritis Cartilage, 2011, 19 (5): 543-
549. https://doi.org/10.1016/j.joca.2010.12.014.
[7] Katz J.N, Arant K.R, Loeser R.F. Diagnosis and
treatment of hip and knee osteoarthritis: A review. JAMA, 2021, 325 (6): 568-578. https://doi.org/10.1001/jama.2020.22171.