arthritis versus bone met

Background:  I had a total (left) hip replacement in 4/08, for OA secondary to AVN.  I was diagnosed with breast cancer (IDC, stage 1, grade 1)  in 5/08.  At the time of diagnosis, I had a base line bone scan, which was clean.   In addition, I had x rays of both hips last year which were normal (except for the prosthesis).

At my two year check-up, my orthopedic surgeon took x-rays of both hips and after glancing at them said the right hip now showed arthritic changes (cysts and bone spurs).  I have had pain in that hip for the past year.  What I do not understand and  my surgeon did not answer is how you differentiate between arthritis and bone mets in an x ray?  The x-rays have not been read by a radiologist, as they were done in house by the orthopedic surgeons tech.  Is it reasonable to have the x-rays read by a radiologist or should I ask my oncologist about a bone scan?  (My oncologist is aware of my ongoing hip pain and has not suggested another bone scan).

[Cleveland Clinic]

Dear lisa_e,  Their are certain features that make findings on an x-ray more or less suspicious for various conditions.  Asking to have the reading of the films confirmed by a radiologist who's expertise is interpretation of x-rays is reasonable.  Discuss your concerns with both your orthopedic surgeon and oncologist - if only that they can discuss with you the findings and be better able to reassure you.