Intended for healthcare professionals


Hip pain and radiographic signs of osteoarthritis

BMJ 2015; 351 doi: (Published 03 December 2015) Cite this as: BMJ 2015;351:h6262
  1. Marc J Nieuwenhuijse, resident in orthopaedic surgery,
  2. Rob G Nelissen, professor
  1. 1Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, Netherlands
  1. Correspondence to: M J Nieuwenhuijse m.j.nieuwenhuijse{at}

Treat patients, not radiographs

Hip pain is common, particularly among adults older than 50 years, and intuitively linked to osteoarthritis. Osteoarthritis refers to a heterogeneous group of joint disorders characterised by progressive destruction of cartilage. Patients present with activity related joint pain and stiffness.1 2 Osteoarthritis can be classified as primary or secondary, but in practice and research the diagnosis is more often categorised as radiographic osteoarthritis, self reported osteoarthritis, or clinical (symptomatic) osteoarthritis. These designations have substantially different prevalences and incidences.2 3 4 Since osteoarthritis is a leading cause of pain and disability, we clearly need a better understanding of its epidemiology, and we need better methods for identifying patients at risk of the debilitating consequences of progressive limitations to daily life caused by symptomatic disease.1 2 5 6

In a linked paper, Kim and colleagues (doi:10.1136/bmj.h5983) address these issues in a cross sectional study of the association between self reported hip pain and radiographic findings suggestive of hip osteoarthritis.7 In …

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