XRAY RIGHT HIP NORMAL SERIES

This research is clear, relying on an x-ray showing hip arthritis in a patient with hip pain as the main reason to perform major surgery like a hip replacement is NOT evidence-based medicine. They found that only 9% of hips in patients with frequent pain showed x-ray evidence of hip arthritis, and 24% of hips with x-ray evidence of hip arthritis were frequently painful! Meaning that again, there was a VERY POOR correlation between what the researchers found on hip x-rays and hip pain. Another even larger government-funded study (OAI) looked at 4,366 hips. Well, maybe this is just one study? Nope. There was a VERY POOR correlation between what the researchers found on hip x-rays and hip pain. On the other hand, only 21% of the patients with hip arthritis on x-rays were frequently painful. Only 16% of hips in patients with frequent hip pain had x-ray evidence of hip arthritis. In the Framingham study, the researchers looked at the hip x-rays of 946 patients. You may recognize the name of the first study as it’s the same town in Massachusetts where the famous heart study was conducted. The research we’ll review is based on data from two government-funded studies: the Framingham Osteoarthritis Study and the Osteoarthritis Initiative Study. However, what if the opposite was true? That people with hip pain often have clean x-rays and that people with evidence of arthritis on their hip x-rays often have no hip pain? First, people with hip pain must have a high likelihood of having arthritis on their hip x-rays, and conversely, people with no hip pain should mostly have clean hip x-rays. Take for example the many hip pain patients that I see in the office who have had a hip replacement, based only on an x-ray and cursory exam.įor us physicians to rely on hip x-rays to make big clinical decisions like hip replacement surgery, a few things need to be true. Remarkably, despite all that we know about the disconnect between what we see in images and pain, many orthopedic surgeries are still launched based on imaging findings. By submitting the form you agree that you've read and consent to our Privacy Policy. We do not sell, or share your information to third party vendors.

XRAY RIGHT HIP NORMAL SERIES

Hence, one bad association between a meniscus tear seen on MRI that has been there for years and sudden knee pain leads to a cascading series of bad decisions that cause patient harm. We also know through multiple randomized controlled trials that any surgery to remove the torn part of the meniscus doesn’t work better than physical therapy or a placebo procedure! (3-7) Finally, we know that this surgery (partial meniscectomy) increases the likelihood of the patient developing knee arthritis (8). Hence, the fact that a meniscus tear was seen after the knee began to hurt is a red herring and usually not the cause of the knee pain. Meaning they are ubiquitous in middle-aged and older people who don’t have knee pain. They are about as important as the wrinkles on your face. Why is this a scam? Because the research on degenerative meniscus tears is crystal clear and has been for some time (1,2). A part of the meniscus is then removed with an arthroscopic procedure, but the knee pain often persists. An MRI shows a meniscus tear and after a cursory exam, surgery is recommended. This one usually begins with a middle-aged patient who feels sudden knee pain when exercising. One of the biggest medical scams of the twentieth century that’s still ongoing is a knee MRI that shows a meniscus tear. Despite this, many invasive surgeries are launched solely based on an x-ray or MRI result and a cursory 2-minute exam in the office.

We’ve known for a long time that images like x-rays and MRIs are really bad at predicting who has pain and who doesn’t. Credit: Shutterstock Pain and Imaging 101

Xray right hip normal