The value of physical examination in the diagnosis of hip osteoarthritis.
OBJECTIVE
To compare the sensitivity of physical examination (internal rotation of the hip) with radiographs (using the Kellgren-Lawrence grading scale) in the diagnosis of clinically significant hip osteoarthritis.


METHODS
Case Series, Retrospective chart review of hip pain patients that underwent fluoroscopically guided hip steroid and anesthetic injections.


METHODS
10 patients with hip pain patients seen at an academic outpatient center over a 2 year period were analyzed.


METHODS
Fluoroscopically guided hip steroid and anesthetic injection.


METHODS
Pain relief and change in VAS pain score after intra-articular hip steroid and lidocaine injection was the main outcome measure.


RESULTS
Based on Fisher's exact test, there was no association between severity of radiographic hip arthritis and pain relief with intra-articular anesthetic/steroid injection (p=0.45). Physical examination (provocative hip internal rotation) however was associated with a significant decrease in VAS pain score after intra-articular lidocaine and corticosteroid hip injection (p=0.022).


CONCLUSIONS
Simple hip radiographs alone are not sufficient to diagnose clinically significant hip osteoarthritis. Physical examination (hip internal rotation) was found to be more accurate than simple radiographs in the diagnosis of clinically significant hip osteoarthritis. Radiographs seem to best utilized when they are an extension of the physical examination and patient history.
Division of Physical Medicine and Rehabilitation, Stanford University School of Medicine, Palo Alto, CA, USA.
Timothy
T
Chong
Darren W
DW
Don
Ming-Chih
MC
Kao
Dexter
D
Wong
Raj
R
Mitra
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D005260:Female; D006621:Hip Joint / Q000000981:diagnostic imaging*; D006801:Humans; D007270:Injections, Intra-Articular; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy; D010146:Pain / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy; D010147:Pain Measurement; D010808:Physical Examination; D011859:Radiography; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones
Hip osteoarthritis; Kellgren-Lawrence; pain; radiographs