Which radiographic findings support the diagnosis of hip osteoarthritis?

• A. Normal X-ray
• B. X-rays showing degenerative changes
• C. Dens fracture on X-ray
• D. Soft tissue swelling on MRI

Answer: (B)

Radiographs reveal the structural changes caused by cartilage loss and bone remodeling in osteoarthritis. In the hip, this classically appears as joint space narrowing from cartilage degeneration, the formation of osteophytes at the joint margins, and subchondral sclerosis; subchondral cysts and eventual deformity of the femoral head or acetabulum may also be seen as the disease advances. These degenerative changes on X-ray directly reflect OA pathology, making them the best imaging evidence for the diagnosis.

A normal X-ray would not explain symptoms, a dens fracture is a spinal injury unrelated to hip OA, and soft tissue swelling seen on MRI is not a typical radiographic hallmark of hip OA.