Did ethics committee consult specialists?

EDITOR—Lanyon et al studied genetic factors associated with osteoarthritis of the hip, but how ethical is it to subject more than 600 healthy participants (siblings of their original cohort) to pelvic radiography?1 The authors used radiographs only as a diagnostic tool. Clinical examination using the Harris hip score would have more accurately obtained the diagnosis with the addition of information concerning loss of function and disease severity. Examination of the patient would have detected and excluded patients with rheumatoid arthritis.

Despite the use of radiographs in this study, no information about the morphology of the hip joints was given. It would have been fascinating to measure the degree of femoral head cover, angle of acetabular inclination, and femoral shaft offset, which govern the magnitude and direction of forces, and the degree of pressure concentration in the joint. Such morphological differences exist between races and are believed to account for differences in prevalence of osteoarthritis and hip dysplasia (G Fuji et al, combined congress of the British and Japanese Orthopaedic Associations, London, October 2000).

If Lanyon et al had undertaken a morphological analysis and found no significant variations between the study and control groups (presuming a similar racial breakdown in both groups, although this information is not given), then—rather …