

The diagnosis of osteoarthritis has often been based on radiographic appearance of the joint space according to the criteria of Kellgren and Lawrence rather than clinical features. However, recent research has shown that radiographic imaging and the amount of pain and limitation a patient experiences does not have as strong of a correlation as once believed. More so, central sensitization and psychosocial factors might play an important role in explaining which patients with radiographic osteoarthritis experience pain and which don’t.
The clinical classification criteria by Altman et al. (1991) have a sensitivity of 86% and a specificity of 75%, which is why we give them a moderate clinical value.
The clinical classification criteria contain the presence of hip pain plus the following items:
OR HIP PAIN plus:
As mentioned earlier, radiographs alone do not define the clinical syndrome of osteoarthritis. Kim et al. (2015) showed in two big cohorts that only 20% of hips with radiographic hip osteoarthritis were frequently painful. This is a good message, as it opens up possibilities for an effective treatment including load management, strengthening, mobility exercises, and maybe more importantly proper patient education and explanation of how psychosocial factors might contribute to the patient’s individual pain experience.
Other assessments for hip osteoarthritis are: