Tests and imaging
How a hip problem is confirmed, and how the right pictures let the surgery be planned in detail before the day itself.
How the picture comes together
A hip diagnosis rests on three things: your history, a physical examination, and imaging. For osteoarthritis, a plain X-ray taken while standing usually confirms the diagnosis and guides what comes next. When surgery is planned, a specific set of X-rays lets the operation be measured out in advance.
Templating X-rays
Measured, not estimated
Before a hip replacement, we take a specific set of X-rays: a low-centred view of the whole pelvis and a side view of the hip, taken to a known scale. Working from these, the surgeon plans the operation on screen ahead of time, a step called templating.
Templating sets the likely implant size, where the socket and stem should sit, and how to match your leg length and the natural offset of the hip. It means the plan is measured to your anatomy before the first cut, and it is confirmed again with live X-ray during surgery.
The low-centred pelvis view matters because it shows both hips together, which is how leg length is judged, and it captures the top of the thigh bone needed to size the stem.
What each one is for
Standing pelvis X-ray
A single X-ray of the pelvis taken while you stand.
The joint space, bone spurs, and the overall shape of both hips. Usually the first and main test.
Side (lateral) hip X-ray
A second X-ray of the hip from the side.
The hip from another angle, which adds to planning and helps size the implant.
CT scan
A detailed set of cross-section images, used only when needed.
Fine bony detail for complex anatomy or revision planning.
MRI
A scan that shows soft tissue as well as bone. Not usually needed for osteoarthritis.
Other causes of hip pain, such as early loss of blood supply to the bone or soft-tissue problems.
Pre-surgery bloodwork
A blood test before surgery.
Your blood count and general health, so any issue can be sorted out before the operation. See getting ready for surgery →
Heart check and clearance
An ECG and, when needed, a review by your family doctor or a specialist.
That you are fit for the anaesthetic and the operation.