Repository logo

Severity mapping of the proximal femur: a new method for assessing hip osteoarthritis with computed tomography.

Change log


Turmezei, TD 
Lomas, DJ 
Hopper, MA 
Poole, KES 


OBJECTIVE: Plain radiography has been the mainstay of imaging assessment in osteoarthritis for over 50 years, but it does have limitations. Here we present the methodology and results of a new technique for identifying, grading, and mapping the severity and spatial distribution of osteoarthritic disease features at the hip in 3D with clinical computed tomography (CT). DESIGN: CT imaging of 456 hips from 230 adult female volunteers (mean age 66 ± 17 years) was reviewed using 3D multiplanar reformatting to identify bone-related radiological features of osteoarthritis, namely osteophytes, subchondral cysts and joint space narrowing. Scoresheets dividing up the femoral head, head-neck region and the joint space were used to register the location and severity of each feature (scored from 0 to 3). Novel 3D cumulative feature severity maps were then created to display where the most severe disease features from each individual were anatomically located across the cohort. RESULTS: Feature severity maps showed a propensity for osteophytes at the inferoposterior and superolateral femoral head-neck junction. Subchondral cysts were a less common and less localised phenomenon. Joint space narrowing <1.5 mm was recorded in at least one sector of 83% of hips, but most frequently in the posterolateral joint space. CONCLUSIONS: This is the first description of hip osteoarthritis using unenhanced clinical CT in which we describe the co-localisation of posterior osteophytes and joint space narrowing for the first time. We believe this technique can perform several important roles in future osteoarthritis research, including phenotyping and sensitive disease assessment in 3D.



Computed tomography, Hip joint, Osteoarthritis, Phenotyping, Aged, Aged, 80 and over, Bone Cysts, Female, Femur Head, Femur Neck, Hip Joint, Humans, Imaging, Three-Dimensional, Middle Aged, Osteoarthritis, Hip, Osteophyte, Severity of Illness Index, Tomography, X-Ray Computed

Journal Title

Osteoarthritis Cartilage

Conference Name

Journal ISSN


Volume Title



Elsevier BV
Arthritis Research Uk (None)
KP acknowledges support of an Arthritis Research UK Research Progression award, and the Cambridge NIHR Biomedical Research Centre (MEBB theme). TT acknowledges the support of an Evelyn Trust Clinical Training Fellowship award. None of the funding sources had a role in study design, data handling, writing of the report, or decision to submit the paper for publication.