Objective. To determine whether 2-dimensional measures of femoral head shape and angle are associated with hip osteoarthritis (OA).Methods. We compared cases with symptomatic radiographic hip OA with asymptomatic controls with no radiographic hip OA. On anteroposterior pelvis radiographs, we measured "pistol grip deformity" for each hip (visually categorized as nonspherical, indeterminate, or spherical), the femoral head-to-femoral neck ratio as an interval measure of femoral head shape, and the femoral neck shaft angle. The relative risk of hip OA associated with each feature was estimated using odds ratios (ORs) and 95% confidence intervals (95% CIs), adjusted for possible confounders using a logistic regression model.
Conclusion.Our findings indicate that pistol grip deformity is associated with hip OA. The increased prevalence of pistol grip deformity and an abnormally low neck shaft angle in unaffected hips of cases with unilateral OA suggests that they are risk factors for development of hip OA. However, both a nonspherical head shape and an increase in neck shaft angle may occur as a consequence of OA.Osteoarthritis (OA) of the hip is an important cause of pain and disability in the community (1,2). As with OA at other sites, hip OA is considered a common complex disorder with multiple genetic, constitutional, and environmental risk factors that result in heterogeneity of phenotype and variability in clinical outcome (3,4). Hip OA shows marked familial predisposition, with heritability estimates of 0.6 in women (5) and up to a 5-fold increased risk in siblings of patients undergoing