UNC study: Blacks just as likely as whites to have hip osteoarthritis

A new study by University of North Carolina at Chapel Hill researchers found that blacks are just as likely as whites to suffer from hip osteoarthritis, challenging accepted medical belief that blacks were somehow protected from this condition.

April 27, 2009

For years many doctors believed that blacks were much less likely than whites to suffer the pain of osteoarthritis in the hip.

But a new study by University of North Carolina at Chapel Hill researchers shows that’s probably not true.

“We were very surprised to find that African Americans had the same amount of X-ray evidence of osteoarthritis in the hip as the whites did,” said Joanne Jordan, M.D., lead author of the study, which is published in the April issue of The Journal of Rheumatology.

“We were also surprised to see that not only was there X-ray evidence of this but there were also symptoms associated with it,” said Jordan, who is director of the UNC Thurston Arthritis Research Center and chief of the division of rheumatology, allergy and immunology.

One person who took part in the study, Jessie Hyman, says she has suffered from hip pain for years, starting soon after the birth of her second child. Many others in her family, including her grandfather, also had hip pain. That’s why, Hyman said, she decided to join UNC’s ongoing Johnston County Osteoarthritis Project.

“I want to know why my granddaddy couldn’t do any better than that, hopped and hurt all the time. There had to be a reason,” Hyman said.

The belief that blacks were protected him hip osteoarthritis was based on results from previous studies of blacks in Africa and the Caribbean, Jordan said. Doctors believed these results would also hold true for blacks born and raised in the U.S., but there had been virtually no research done to test the question, Jordan said.

Jordan and colleagues set out to do just that. Using data collected from the Johnston County Osteoarthritis Project, they calculated prevalence estimates by age, sex and race for four separate hip outcomes: self-reported hip pain, X-ray evidence of hip osteoarthritis, symptoms of hip osteoarthritis and X-ray evidence of severe hip osteoarthritis.

The results show that blacks were just as likely as whites to have these four outcomes.

Jordan says these results suggest there may be an unmet need in caring for black patients with hip osteoarthritis and suggest that racial disparities in the use of hip replacement surgery are not because African Americans have less disease or less severe disease. It also shows there may be a need for education of health care providers on this issue, she said.

“If this is a concept in their minds that African Americans just don’t get hip osteoarthritis, they may not be thinking of hip osteoarthritis as a diagnosis for some of the symptoms that patients may come in with,” Jordan said.

The study is available online at http://www.jrheum.org/content/36/4/809.full.

School of Medicine contacts: Stephanie Crayton, (919) 966-2860, scrayton@unch.unc.edu or Tom Hughes, (919) 966-6047 or tahughes@unch.unc.edu.

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