Structural Peculiarities of the Proximal Femur Meta-Epiphysis in the Idiopathic Coxarthrosis According to Localization

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Figure 2. Femoral neck angle, X-ray proximal meta-epiphysis of the human femur; AP view

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Figure 3. Greater trochanteric angle, proximal meta-epiphysis of the human femur; X-ray AP view

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Figure 4. Angle of entry of diaphyseal canal, proximal meta-epiphysis of the human femur; X- ray AP view

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2.2. Sample Analysis and Assessment

The control group consisted of AP X-ray films of twelve (12) right and fourteen (14) left hips free from any pathological signs or predicaments. In parallel, a group of forty-nine (49) X-ray films of the hip with idiopathic joint arthrosis (24 right-sided and 25 left-sided) were staged and analyzed (Table 1; Figure 5, Figure 6 and Figure 7), where a 3-point scale was used to evaluate the degree of deviation of the vertex in the angle of entry to the diaphyseal canal as regards the diaphysis axis (1 point: medial displacement; 2 points: normal location and 3 points: lateral displacement). The average values of the proximal femoral bone meta-epiphyses have been tabulated taking into account the stage of disease and localization to the left or right side of the body (Table 2).

Analytically, all received data of linear parameters have been standardized with transverse size of the diaphysis as a measurement unit for each bone and processed according to methods of descriptive and variation statistics (statistical package-Microsoft Excel 2013), as previously indicated ^{[13, 21]}. Statistical difference was considered authenticated with α= 0.05.

Figure 5. X-ray film of coxarthrosis stage I. A: Marginal osteophytes

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Figure 6. X-ray film of coxarthrosis stage II. A: Marginal osteophytes; B: Deformity of the femoral head

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Figure 7. X-ray film of coxarthrosis stage III. A: Marginal osteophytes; B: Marked deformities of the femoral head; C: Complete destruction of the intra-articular cartilage

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3. Results and Discussion

The results therein reported indicate that the radiological images of the idiopathic hip arthrosis (IHA) patients have a relatively increased femoral head and neck vertical diameter (expressed in a relative measurement unit) (Table 1; Figure 1,Figure 2, Figure 3, and Figure 4). With weighing of the main pathology stream of thinking, and in our opinion, this technically indicates a change in the qualitative characteristics of the functional stress volume of the femoral bone ^{[22, 23, 24, 25]}.

Initially, there is a decrease in the exertion support and as a result some reduction of average absolute values of the transverse diaphysis was observed thus leading to a relative increase in the abovementioned parameters ^{[26, 27, 28, 29, 30, 31, 32]}. The changes in degenerative and dystrophic hip joint diseases are confirmed by statistically establishing a decrease in the transverse proximal epiphysis size (Table 2) that can be explained by the external rotation, which is a manifestation of forced rearrangement in alleviating pain. In addition, this phenomenon is shown by the lateralization value of the vertical angle in the diaphyseal canal in the groups of right- and left-sided IHA ^{[5, 6, 7, 8, 13, 21, 33, 24, 35]}.

Nevertheless, comparing the intensity and degree of confidence intervals range in all radiological studies has shown that left-sided localization of the pathological process leads to a more significant and prominent reorganization of the proximal femoral bone epiphysis ^{[13, 21, 36, 37, 38, 39, 40, 41, 42]}. The range of confidence interval of the values of the proximal epiphysis transverse size in stage II of IHA is, however, less than that observed in the left- sided localization.

Table 1. Qualitative distribution of the X-ray images of the patients with hip joint idiopathic arthrosis according to the stage of disease and body side

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Tables index

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Table 2. Width of linear and angulated confidence interval parameters of the proximal femoral bone meta-epiphysis in normal condition and idiopathic hip arthrosis with α= 0.05. * Indicates the authenticity of difference with the control group. ** Indicates the authenticity of difference with the group of IHA at stages II and III

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