Radiology now. Osteoarthrosis of the hip: one disease or many?

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Abstract
Osteoarthrosis of the hip is a common disorder. Traditionally, osteoarthrosis is separated into primary and secondary types; the term secondary osteoarthrosis is applied where change is superimposed on the preceding abnormality of the hip. It is suggested that minor joint dysplasia or deformity may predispose to degenerative change. It is possible, radiologically, to recognize the shallow sloping dysplastic acetabulum, and although it is not proven that such patients form part of the spectrum of congenital dislocation per se, alterations in joint mechanics may result in osteoarthrosis. Murray has drawn particular attention to the tilt deformity in certain femoral heads affected by degenerative change. Another pattern of osteoarthrosis is that associated with protrusio acetabuli. Severe distructive change in the hips, often with radiological features of aseptic necrosis, may follow therapy with corticosteroids. These various starting point suggest that osteoarthrosis is due to a mixture of inherited and environmental factors. The radiologist is unable to recognize the early disease, often unable to predict the symptomatic patient, but able to identify various patterns of joint disease, the significance of which is not always clear.

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