Current and Future Advanced Imaging Modalities for the Diagnosis of Early Osteoarthritis of the Hip

Abstract

Hip osteoarthritis (OA) can be idiopathic or develop secondary to structural joint abnormalities of the hip joint (alteration of normal anatomy) and/or due to a systemic condition with joint involvement. Early osteoarthritic changes to the hip can be completely asymptomatic or may cause the development hip symptomatology without evidence of OA on radiographs. Delaying the progression of hip OA is critical due to the significant impact of this condition on the patient’s quality of life. Pre-OA of the hip is a newly established term that is often described as the development of signs and symptoms of degenerative hip disease but no radiographic evidence of OA. Advanced imaging methods can help to diagnose pre-OA of the hip in patients with hip pain and normal radiographs or aid in the surveillance of asymptomatic patients with an underlying hip diagnosis that is known to increase the risk of early OA of the hip. These methods include the delayed gadolinium-enhanced magnetic resonance imaging (MRI) of cartilage (dGEMRIC), quantitative magnetic resonance imaging (qMRI- T1rho, T2, and T2* relaxation time mapping), 7-Tesla MRI, computed tomography (CT), and optical coherence tomography (OCT). dGEMRIC proved to be a reliable and accurate modality though it is limited by the significant time necessary for contrast washout between scans. This disadvantage is potentially overcome by T2 weighted MRIs, which do not require contrast. 7-Tesla MRI is a promising development for enhanced imaging resolution compared to 1.5 and 3T MRIs. This technique does require additional optimization and development prior to widespread clinical use. The purpose of this review was to summarize the results of translational and clinical studies investigating the utilization of the above-mentioned imaging modalities to diagnose hip pre-OA, with special focus on recent research evaluating their implementation into clinical practice.

Hip and Knee Osteoarthritis in Patients with Chronic Myeloproliferative Neoplasms: A Cross-Sectional Study

“…), which could help to slow down the progression of OA. However, further studies are needed to evaluate whether other more powerful imaging techniques (i.e., magnetic resonance-MR or computed tomography-CT) may show even earlier and possibly more specific, “MPN-related”, morphological changes of the joints [ 9 ], as well as whether MPN specific therapies may positively affect OA course and its associated complications.…”

“…OA can affect any joint, but the hips, knees, and hands are the most commonly affected ones [ 5 ]. The prevalence of radiographic knee and hip OA are up to 28% [ 6 , 7 , 8 , 9 , 10 ]. On the other hand, symptomatic OA (sOA) and radiologically confirmed OA have a much lower incidence (up to 17% for knee OA and 9% for hip OA) because radiographic OA can also be asymptomatic [ 11 ].…”

Imaging of early-stage osteoarthritis: the needs and challenges for diagnosis and classification

“…With T2 mapping, it is possible to determine the amount and network integrity of collagen, while other techniques such as T1ρ, GagCEST, and sodium MRI have been shown to be capable of assessing the amount of proteoglycans [ 18 ]. These quantitative MRI techniques have been mostly applied to the knee, followed by the hip joint [ 19 , 20 ]. When a gadolinium contrast agent is administered, it is possible to reliably assess synovitis in the joint [ 21 ], and when this is combined with a dynamic contrast-enhanced MRI (DCE-MRI) acquisition, it is possible to quantitatively characterize the perfusion in the synovium [ 22 ] and other tissues and lesions that have been linked to inflammatory pathways in OA, such as the infrapatellar fad pad [ 23 ] and bone marrow lesions [ 24 ].…”

A genome-wide association study identifies genetic variants associated with hip pain in the UK Biobank cohort (N=221,127)

“…Traditionally defined, hip pain denotes any sensation of unease or suffering encountered within the expanse between the upper thigh and the pelvis, frequently emanating from the hip joint itself or the encompassing anatomical structures (Mills et al 2022). Hip pain is an incapacitating affliction affecting a substantial portion of the global population (Elbrhamy et al 2023).…”