The authors compared seven radiologic indices of hip osteoarthritis to establish which provided the best definition of the disease for epidemiologic purposes. Hip joints were assessed from intravenous urograms taken in a British hospital between 1982 and 1987 in 1,315 men aged 60-75 years. The indices examined were an overall qualitative grading of osteoarthritis, four measures of joint space, the maximum thickness of subchondral sclerosis, and the size of the largest osteophyte. Minimal joint space (i.e., the shortest distance between the femoral head margin and the acetabulum) was the index most strongly associated with other radiologic features of osteoarthritis. Among a subset of 759 men who answered a questionnaire about symptoms, the overall qualitative grading, minimal joint space, and thickness of subchondral sclerosis were the radiologic indices most predictive of hip pain. Within- and between-observer repeatability were tested in a subset of 50 subjects. Measures of joint space were more reproducible than other indices. These data suggest that, at least in men, minimal joint space is the best radiologic criterion of hip osteoarthritis for use in epidemiologic studies.

week. Soya bean curd, which is an important potential source of calcium in the Chinese diet, was eaten at least once a week by 35% of controls but by only 27% of patients. In contrast to the data from Southampton, calcium was found to protect against fracture in both women and men. In the past low calcium intake might have been offset by a high level of weight bearing physical activity, which maintained bone mass. The decline in activity which followed the construction of high rise apartments and the disappearance of walking space may have unmasked the adverse skeletal effect of a low calcium intake.Public health strategies to reduce the rising incidence of hip fractures in urbanising oriental populations are urgently required. Our results point to the importance of maintaining physical activity and calcium intake in elderly Chinese people who grew up in rural communities, characterised by high levels of physical activity and a diet low in calcium, but are now mostly living in flats in high rise buildings while continuing to eat a traditional diet. Abstract Regular exercise and high calcium intake possibly helpto preserve bone mass. Little is known, however, about their role in preventing hip fracture. The physical activity and calcium intake of 300 elderly men and women with hip fractures were compared with those of 600 controls matched for age and sex. In both sexes increased daily activity, including standing, walking, climbing stairs, carrying, housework, and gardening protected against fracture. This was independent of other known risk factors, including body mass, cigarette smoking, and alcohol consumption. Strength of grip correlated with activity and was inversely related to the risk of fracture. Calcium intake was not related to the risk of fracture in women. Men with daily calcium intakes above ig had lower risks.These findings point to the importance of elderly people in Britain maintaining physical activity in their day to day lives.

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