Limits...
The Pathophysiology and Progression of Hip Osteoarthritis Accompanied with Joint Pain are Potentially Due to Bone Alterations - Follow-up Study of Hip OA Patients.

Kamimura M, Nakamura Y, Uchiyama S, Ikegami S, Mukaiyama K, Kato H - Open Rheumatol J (2014)

Bottom Line: Joint pain disappeared or was markedly improved in all 10 cases in Group A.The mean age of Group B was significantly higher than that of Group A.These findings indicate that the pathophysiology of OA, joint pain, and OA progression may primarily be due to bone changes.

View Article: PubMed Central - PubMed

Affiliation: Center of Osteoporosis and Spinal Disorders: Kamimura Orthopaedic Clinic, Matsumoto 399-0021, Japan.

ABSTRACT

Objectives: This study examined hip osteoarthritis (OA) patients with joint pain and accompanying signal changes detected by magnetic resonance imaging (MRI).

Methods: A total of 19 hip OA patients with suddenly occurring or worsening pain regardless of Kellgren-Lawrence grading were enrolled. The patients were monitored using MRI, plain radiographs, and the Denis pain scale for a minimum of 6 months. The patients were classified into 2 groups: those whose pain improved during conservative treatment (Group A) and those whose pain persisted (Group B).

Results: Joint pain disappeared or was markedly improved in all 10 cases in Group A. Radiographic OA progression occurred in 7 of 8 cases with available radiographs. Hip MRI was performed on 7 of 10 patients, among whom bone signal changes disappeared in 6 patients. One patient exhibited persisting bone signal alterations although joint pain had completely disappeared. In Group B, joint pain remained in all 9 cases. Radiographic OA progression occurred in 8 of 9 cases, and local (4 cases) or broad (5 cases) bone signal alterations were present in end-point MRI examinations. Two patients exhibited different regional MRI bone signal changes (local or broad) at the end of follow-up. The mean age of Group B was significantly higher than that of Group A.

Conclusion: THIS STUDY UNCOVERED THE FOLLOWING OBSERVATIONS: 1) hip OA with joint pain had bone alterations that were detectable by MRI, 2) these bone alterations disappeared when joint pain improved, 3) bone alterations remained when joint pain continued, and 4) radiographic OA progressed to a more advanced stage over a short time period. These findings indicate that the pathophysiology of OA, joint pain, and OA progression may primarily be due to bone changes.

No MeSH data available.


Related in: MedlinePlus

Plain radiograph taken as right hip joint pain persistsshowing KL grading II hip OA. Increased joint space narrowing isseen in the right hip joint (black arrows).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4192849&req=5

F2f: Plain radiograph taken as right hip joint pain persistsshowing KL grading II hip OA. Increased joint space narrowing isseen in the right hip joint (black arrows).

Mentions: A 63-year-old woman presented with the chief complaint of severe right hip joint pain. Plain radiographs of the affected joint showed moderate OA of KL grading II (Fig. 2a). Within a month after pain onset, hip MRI displayed broad and heterogeneous low intensity in T1W and high intensity in STIR images (Fig. 2b, c). At more than 6 months after onset, hip MRI showed no signal changes (Fig. 2d-f) and plain radiographs revealed increased joint space narrowing and KL grading II (Fig. 2f). Her joint pain had disappeared by that time.


The Pathophysiology and Progression of Hip Osteoarthritis Accompanied with Joint Pain are Potentially Due to Bone Alterations - Follow-up Study of Hip OA Patients.

Kamimura M, Nakamura Y, Uchiyama S, Ikegami S, Mukaiyama K, Kato H - Open Rheumatol J (2014)

Plain radiograph taken as right hip joint pain persistsshowing KL grading II hip OA. Increased joint space narrowing isseen in the right hip joint (black arrows).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4192849&req=5

F2f: Plain radiograph taken as right hip joint pain persistsshowing KL grading II hip OA. Increased joint space narrowing isseen in the right hip joint (black arrows).
Mentions: A 63-year-old woman presented with the chief complaint of severe right hip joint pain. Plain radiographs of the affected joint showed moderate OA of KL grading II (Fig. 2a). Within a month after pain onset, hip MRI displayed broad and heterogeneous low intensity in T1W and high intensity in STIR images (Fig. 2b, c). At more than 6 months after onset, hip MRI showed no signal changes (Fig. 2d-f) and plain radiographs revealed increased joint space narrowing and KL grading II (Fig. 2f). Her joint pain had disappeared by that time.

Bottom Line: Joint pain disappeared or was markedly improved in all 10 cases in Group A.The mean age of Group B was significantly higher than that of Group A.These findings indicate that the pathophysiology of OA, joint pain, and OA progression may primarily be due to bone changes.

View Article: PubMed Central - PubMed

Affiliation: Center of Osteoporosis and Spinal Disorders: Kamimura Orthopaedic Clinic, Matsumoto 399-0021, Japan.

ABSTRACT

Objectives: This study examined hip osteoarthritis (OA) patients with joint pain and accompanying signal changes detected by magnetic resonance imaging (MRI).

Methods: A total of 19 hip OA patients with suddenly occurring or worsening pain regardless of Kellgren-Lawrence grading were enrolled. The patients were monitored using MRI, plain radiographs, and the Denis pain scale for a minimum of 6 months. The patients were classified into 2 groups: those whose pain improved during conservative treatment (Group A) and those whose pain persisted (Group B).

Results: Joint pain disappeared or was markedly improved in all 10 cases in Group A. Radiographic OA progression occurred in 7 of 8 cases with available radiographs. Hip MRI was performed on 7 of 10 patients, among whom bone signal changes disappeared in 6 patients. One patient exhibited persisting bone signal alterations although joint pain had completely disappeared. In Group B, joint pain remained in all 9 cases. Radiographic OA progression occurred in 8 of 9 cases, and local (4 cases) or broad (5 cases) bone signal alterations were present in end-point MRI examinations. Two patients exhibited different regional MRI bone signal changes (local or broad) at the end of follow-up. The mean age of Group B was significantly higher than that of Group A.

Conclusion: THIS STUDY UNCOVERED THE FOLLOWING OBSERVATIONS: 1) hip OA with joint pain had bone alterations that were detectable by MRI, 2) these bone alterations disappeared when joint pain improved, 3) bone alterations remained when joint pain continued, and 4) radiographic OA progressed to a more advanced stage over a short time period. These findings indicate that the pathophysiology of OA, joint pain, and OA progression may primarily be due to bone changes.

No MeSH data available.


Related in: MedlinePlus