The Pathophysiology of Primary Hip Osteoarthritis may Originate from Bone Alterations

Mikio Kamimura1, Yukio Nakamura*, 2, 3, Shota Ikegami2, Keijiro Mukaiyama2, Shigeharu Uchiyama2, Hiroyuki Kato2
1 Center of Osteoporosis and Spinal Disorders: Kamimura Orthopaedic Clinic, Matsumoto, 399-0021, Japan
2 Department of Orthopaedic Surgery, Shinshu University School of Medicine, Asahi3-1-1, Matsumoto, 390-8621, Japan
3 Department of Orthopaedic Surgery, Showa Inan General Hospital, Komagane, 399-4117, Japan

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© Kamimura et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Orthopaedic Surgery, Shinshu University School of Medicine, Asahi3-1-1, Matsumoto, 390-8621, Japan; Tel: +81-263-37-2659; Fax: +81-263-35-8844; E-mail:



The aim of this study was to investigate whether bone alterations detected by hip magnetic resonance imaging (MRI) were associated with subsequent primary hip OA.


We enrolled 7 patients with hip joint pain from their first visit, at which hip joints were classified as grade 0 or I on the Kellgren-Lawrence grading scale. Plain radiographs and magnetic resonance imaging (MRI) were performed on all cases, and pain was assessed with the Denis pain scale. Average age, height, weight, body mass index, bone mineral density (L1-4), central edge angle, Sharp’s angle, and acetabular hip index were calculated.


Within two months of the onset of pain, 4 of the 7 cases showed broad bone signal changes, while 3 cases showed local signal changes in the proximal femur on hip MRI. Three to 6 months after the onset of pain, in all patients whose pain was much improved, plain radiographs showed progression to further-stage OA.


Our findings suggest that bone abnormalities in the proximal femur might be involved in the pathogenesis of primary hip OA.

Keywords: : Pathophysiology, bone, hip osteoarthritis, MRI, joint pain..