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arthritic hip versus bone met

I was diagnosed with breast cancer in 2008.  I also had a total hip replacement (left side) in the same year, for OA, secondary to AVN.

For the past year, I have had pain in my right hip.  The pain comes and goes.  X-rays were normal.

This month, when I saw my orthopedic surgeon for a 2 year follow up, the x-ray of my natural hip showed some changes.   My surgeon glanced at the x-ray and said I was developing cysts on the ball of the femur.  There is also a bone spur on the neck of the femur.  According to my surgeon, these changes are early signs of arthritic changes in my hip.  I am willing to believe that, but I do not understand how he can determine the cause of the changes in my hip by just glancing at the x-ray.  What testing is normally done to differentiate between osteoarthritis and bone mets?  

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25201 tn?1255580836
All and any films that are taken are read by a Radiologist ... I suggest that you request the final report and go over that with your Oncologist or your Primary Care Physician. Glancing at a film isn't "reading" so you shouldn't be expected to settle for an answer based on that observation. You can certainly insist on further testing and if it is denied then consult another Oncologist for a second opinion.   Good Luck .....
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Avatar universal
Japdip,  a radiologist never looked at the films.  My surgeon just glanced at them and mentioned the changes.  I could clearly see the changes and know that the xray is different from last year.  I would be more confident if an radiologist had read the films.  

I have been complaining of hip pain for a year, to my oncologist and my pc doc.  They have not suggested any tests, except  x-rays a year ago which were normal.  I believe the assumption is that because my breast cancer was early they think further testing is not indicated.    At this point, with the changes in my x-ray, I think it is time to revisit the issue.
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25201 tn?1255580836
You might ask about a Bone Scan from your Oncologist .... I'm quite sure the Radiologist would have read your films differently had there been any indication of bone mets. It's been my personal experience that mets. is the FIRST thing mentioned on my Radiology reports even when the problem was an Orthopaedic issue. Generally regular X-rays aren't the best method to differentiate between the two. If I were you I would pursue the Bone Scan examination but as I mentioned above your Oncologist would be your best choice for having this done.    Regards ....
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