title: Sonographic evaluation of hip joint effusion in osteoarthritis with correlation to radiographic findings.
abstract: OBJECTIVE
  Hip joint effusion is expected in rapidly destructive osteoarthritis, a diagnosis often only made retrospectively at the end stage of the disease. This study assesses whether the presence of an effusion identified during routine ultrasound-guided hip injection may suggest a more aggressive process such as rapidly destructive osteoarthritis.
  
  
  METHODS
  After the observation of 10 index cases of rapidly destructive osteoarthritis in patients who presented with a joint effusion on ultrasound, we retrospectively reviewed 94 hips from 89 patients who underwent ultrasound-guided hip injection for pain. Preinjection longitudinal ultrasound images of the anterior capsule adjacent to the femoral neck and inferior to the femoral head were reviewed to determine if a joint effusion was present and the size of the effusion if one was there. Comparison of effusion size was then made between those hips that had a clinical and radiographic diagnosis of osteoarthritis and those who had rapidly destructive osteoarthritis by comparing the severity of joint effusion, if one was present.
  
  
  RESULTS
  Patients with rapidly destructive osteoarthritis were more likely to have a large joint effusion 60% (3/5) than were those with osteoarthritis 6.7% (6/89) (p = 0.013).
  
  
  CONCLUSIONS
  Large joint effusions identified sonographically correlate well with radiographic findings of rapidly destructive osteoarthritis. Given rapid onset and severity of the disease, when a large joint effusion is identified on routine hip intervention, patients should be forewarned of the potential for this disease process.
authors.affiliation: Henry Ford Hospital, Department of Radiology, 2799 West Grand Boulevard, Detroit, MI, 48202.
authors.forename: Jeff
authors.initials: J
authors.lastname: Birn
authors.forename: Ryan
authors.initials: R
authors.lastname: Pruente
authors.forename: Raluca
authors.initials: R
authors.lastname: Avram
authors.forename: William
authors.initials: W
authors.lastname: Eyler
authors.forename: Meredith
authors.initials: M
authors.lastname: Mahan
authors.forename: Marnix
authors.initials: M
authors.lastname: van Holsbeeck
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006621:Hip Joint / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D015588:Observer Variation; D010003:Osteoarthritis / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D011859:Radiography; D012720:Severity of Illness Index; D014463:Ultrasonography
keywords: hip joint effusion; musculoskeletal; osteoarthritis; rapidly destructive osteoarthritis; ultrasound