Is Hip Arthritis a Bone Disease?

Serial MRI images were able to detect either broad band or localized signal changes in proximal femur during a period of hip pains. Subsequently, the hip pains may resolve but hip OA changes appeared on imaging. This  chronologs  the process – bone damage that resolves but cartilage damage follows…

Open Rheumatol J. 2013 Nov 29;7:112-8.
The Pathophysiology of Primary Hip Osteoarthritis may Originate from Bone Alterations.
Kamimura M,Nakamura , Ikegami S, Mukaiyama K,  Uchiyama S, Kato H.

  •   7 cases average age 70 –  6 female; 1 male
  • seen with acute onset a pains with walking – no trauma
  • “Within two months of the onset of pain, hip MRI was performed and revealed that all 7 cases showed low intensity by T1W and high intensity by T2-STIR in the proximal femur.”
  • 4 had broad based changes; 3 were more localized
  • 3- 6 months after –  xrays in all patients whose pain had been much improved, had progression of OA.
  • suggested that OA hip can result from pathological bone changesand referred to other articles that found subchondral bone changes causing OA ?imbalanced bone remodelling
  • Comment on how Alendonate and Risedronate Bone building Biphosphates appear to help OA prehaps by preventing bone microfractures.

Comment – does appear that OA is partly a bone disease. Wonder if Hyperbaric oxygen given daily during the episode of hip pain could have prevented the subsequent degeneration. They make a case for using biphosophantes; Evista has also been shown to help knee and back pains.

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