Study question Is there concordance between hip pain and radiographic hip osteoarthritis? Methods In this diagnostic test study, pelvic radiographs were assessed for hip osteoarthritis in two cohorts: the Framingham Osteoarthritis Study (community of Framingham, Massachusetts) and the Osteoarthritis Initiative (a multicenter longitudinal cohort study of osteoarthritis in the United States). Using visual representation of the hip joint, participants reported whether they had hip pain on most days and the location of the pain: anterior, groin, lateral, buttocks, or low back. In the Framingham study, participants with hip pain were also examined for hip pain with internal rotation. The authors analysed the agreement between radiographic hip osteoarthritis and hip pain, and for those with hip pain suggestive of hip osteoarthritis they calculated the sensitivity, specificity, positive predictive value, and negative predictive value of radiographs as the diagnostic test. Study answer and limitations In the Framingham study (n=946), only 15.6% of hips in patients with frequent hip pain showed radiographic evidence of hip osteoarthritis, and 20.7% of hips with radiographic hip osteoarthritis were frequently painful. The sensitivity of radiographic hip osteoarthritis for hip pain localised to the groin was 36.7%, specificity 90.5%, positive predictive value 6.0%, and negative predictive value 98.9%. Results did not differ much for hip pain at other locations or for painful internal rotation. In the Osteoarthritis Initiative study (n=4366), only 9.1% of hips in patients with frequent pain showed radiographic hip osteoarthritis, and 23.8% of hips with radiographic hip osteoarthritis were frequently painful. The sensitivity of definite radiographic hip osteoarthritis for hip pain localised to the groin was 16.5%, specificity 94.0%, positive predictive value 7.1%, and negative predictive value 97.6%. Results also did not differ much for hip pain at other locations. What this study adds Hip pain was not present in many hips with radiographic osteoarthritis, and many hips with pain did not show radiographic hip osteoarthritis. Most older participants with a high suspicion for clinical hip osteoarthritis (groin or anterior pain and/or painful internal rotation) did not have radiographic hip osteoarthritis, suggesting that in many cases, hip osteoarthritis might be missed if diagnosticians relied solely on hip radiographs. Funding, competing interests, data sharing See the full paper on thebmj.com for funding. The authors have no competing interests. Additional data are available from bevochan@bu.edu .

Objectives The last prevalence survey encompassing urban populations was part of the nationwide Health and Nutrition examination survey (NHANES I) in the 1970's. We carried out a prevalence survey for hip osteoarthritis (OA) in the Framingham Study Community cohort. Methods Persons age 50 and older living in Framingham in 2002 – 2005 were recruited by random digit dialing without respect to joint pain or arthritis. Anteroposterior standing long-limb radiographs of the lower extremities including the pelvis were obtained and read for radiographic hip OA (ROA) by two trained physicians with all possible cases of ROA confirmed by an experienced musculoskeletal radiologist. ROA was defined as Kellgren-Lawrence score ≥ 2. Using a homunculus in which the hip joint was depicted, participants were asked whether they had hip pain on most days. Those who said ‘yes’ were defined as having hip pain. Symptomatic hip OA (SxOA) was defined as radiographic OA with ipsilateral hip pain. We defined a person as having hip OA if at least one of their hip joints was affected. Results Of 978 subjects studied (mean age 63.5 years; 56% women), age-standardized prevalence of ROA was 19.6% (95% CI 16.7%-23.0%) and SxOA was 4.2% (95% CI 2.9%-6.1%%). Overall, we found that men had higher prevalence of ROA (p<0.0001) compared to women, but men did not have a higher prevalence of SxOA compared to women (5.2% vs 3%, p=0.08). Conclusion In conclusion, hip osteoarthritis is a common condition in middle aged and older persons in urban and suburban U.S.

Primary rabbit tracheal epithelial cells growing on either plastic surface or collagen gel produce high molecular weight glycoconjugates. Biochemical characterization of these materials show they are exclusively hyaluronic acid when cells are grown on plastic surface, but a mixture of hyaluronic acid and mucin-like glycoproteins when grown on collagen gel. This research suggests that the substratum plays an important role in the maintenance or differentiation or both of mucous cells in culture.

Very promising results have been obtained in clinical trials on chronic-phase chronic myeloid leukemia (CP-CML) patients treated with imatinib mesylate (IM; Gleevecr, STI571), a BCR-ABL tyrosine kinase inhibitor. However, we found that IM caused considerable inhibition of normal hematopoietic progenitor cells upon treating control bone marrow (BM) cultures. In vitro IM treatment gave a decrease in the yield and size of colonies from BM of untreated CP-CML patients that was only two to three times that from the normal samples. Moreover, about 30% of myeloid progenitors (CFU-GM) from CML BM still formed colonies in the presence of IM, most of which had BCR-ABL RNA. About half of these treated colonies also displayed methylation of the internal ABL Pa promoter, a CML-specific epigenetic alteration, which was used in this study as a marker for BCR-ABL translocation-containing cells. However, ~5-8% of the treated or the untreated CML BM-derived colonies had no detectable BCR-ABL RNA by two or three rounds of RT-PCR despite being positive for the internal standard RNA and displaying hallmarks of CML, either t(9;22)(q34;ql 1) or ABL Pa methylation. Our results indicate that IM is only partially specific for CML progenitor cells compared to normal hematopoietic progenitor cells and suggest that some CML cells may have a silent BCR-ABL oncogene that could interfere with therapy.

Objective Studies suggest that persons with a 2 cm shorter limb have an increased risk of knee osteoarthritis (OA) in that limb. We examined whether leg length inequality (LLI) confers an increased risk of hip OA. Methods Using long limb radiographs from MOST and the Osteoarthritis Initiative, we measured LLI and scored hip radiographs which were obtained at baseline and 3–5 year follow-up. We examined the association of ≥1 cm LLI and ≥2 cm of LLI with radiographic hip OA cross-sectionally and longitudinally, assessing risk in shorter limbs and longer limbs compared with limbs with no LLI. We carried out logistic regression analyses with GEE and adjusted for age, sex, BMI, height and cohort of origin. Results In MOST, we studied 1,966 subjects and in OAI 2,617 subjects. 12% of persons had LLI of ≥1 cm and 1% had LLI of ≥2 cm. For LLI ≥1 cm, the adjusted OR for prevalent hip OA in the shorter leg was 1.47 (95% CI 1.07–2.02) and for LLI ≥2 cm, it was 2.15 (95%CI 0.87–5.34). For LLI ≥1 cm, the odds of incident hip OA in the shorter leg was 1.39 (95%CI 0.81–2.39) while for LLI ≥2 cm, the odds in the shorter leg was 4.20 (95%CI 1.26 – 14.03), We found no increased risk of hip OA in longer limbs. Conclusion Our findings suggest that, like knee OA, limbs at least 2 cm shorter are at increased risk of hip OA.