The authors have shown that the initial phase of coxarthrosis consists purely of cartilaginous lesions, not visible in radiographs. They have studied 200 arthrograms of the hip using a precise technique which is described. They have found cartilaginous lesions both in cases of insufficiency of the lateral wall of the acetabulum, and in cases of insufficiency of the medial wall of the acetabulum. Cartilaginous lesions may range between a simple decrease of articular cartilage height and complete ulceration either on the cephalic or acetabular sides. These lesions may be present at a time when the radiograph is still normal, especially in cases of hip dysplasia. It is concluded that the articular cartilage of the hip may chondromalacic in the same way as in the patello-femoral joint, and that arthrosis may be secondary to this chondromalacia. Arthrography makes early diagnosis possible.
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