# Diagnostic Performance of Ultrasound to Evaluate Mild Hip Osteoarthritis: Comparison With Radiography and MRI

## TL;DR

This study compares ultrasound with X-rays and MRI for diagnosing mild hip osteoarthritis, finding similar moderate diagnostic performance and pain associations.

## Contribution

The study demonstrates that ultrasound has comparable diagnostic performance to X-rays for mild hip osteoarthritis when compared to MRI.

## Key findings

- Ultrasound and radiography showed similar moderate diagnostic performance for mild hip osteoarthritis compared to MRI.
- Ultrasound sum scores and Kellgren-Lawrence grades were both associated with increased hip pain.
- Ultrasound and radiography capture different aspects of hip osteoarthritis, suggesting complementary use.

## Abstract

To study the diagnostic performance of ultrasound (US) in mild hip osteoarthritis (HOA) compared to conventional radiography (CR) and magnetic resonance imaging (MRI).

Fifty‐eight patients referred to CR for suspected HOA with at least unilateral Kellgren‐Lawrence (KL) 2 change in the CRs were recruited. Bilateral hip US and MRI (n = 116) were performed, and patients filled the Visual Analog Scale (VAS) bilaterally. A sum US score was formed, and its correlation to KL grades and VAS scores was tested. Descriptive statistics, Chi square and McNemar's test, Spearman correlation, and linear regression analysis were applied as statistical techniques.

US and CR showed similar moderate diagnostic performance compared to MRI with moderate correlation (r = 0.449) between US sum score and KL grades. With pain associations, US sum score showed an OR = 1.725 (CI 1.169–2.546) and KL grades an OR = 2.058 (CI 1.038–4.082).

US and CR demonstrated similar moderate diagnostic capability in detecting mild HOA compared to MRI, and both the US sum score and KL grades were associated with increased hip pain. With US and CR demonstrating different aspects of HOA, our findings support the complementary role of US in evaluating patients with suspected HOA.

A moderate‐sized femoral neck osteophyte (white arrow) in US (A), anteroposterior CR (B), and MRI (C). Additional osteoarthritis‐related changes (arrowheads) are visible in CR and MR, but not in US. US and CR demonstrated similar moderate diagnostic capability to detect mild hip osteoarthritis and were associated with increased hip pain.