Jacobsen Steffen, Sonne-Holm Stig, Søballe Kjeld, Gebuhr Peter, Lund Bjarne
Department of Orthopaedic Surgery, Copenhagen University Hospital, Rigshospitalet, Denmark.
Osteoarthritis Cartilage. 2004 Sep;12(9):704-10. doi: 10.1016/j.joca.2004.05.003.
The aims of this study were to investigate the influence of sex, age and individual physical and occupational factors on the distribution of radiographic features of hip joint osteoarthritis (OA), and to determine the inter-relationships between the primary radiographic OA discriminator of reduced joint space width (JSW), and secondary radiographic OA features.
The study was a cross-sectional survey. Radiologic features of hip OA were recorded from standardized, standing pelvic radiographs of 3686 subjects (1397M/2289F). OA features were investigated for inter-relationships and correlations to age, sex, body mass index (BMI) and occupational exposure to repeated lifting.
Overall, subchondral sclerosis, cysts and osteophytes were more frequently recorded in male hip joints compared to female hip joints, while a decrease in minimum JSW by age was more pronounced and progressive in women after the fifth decade compared to men. Applying logistic regression analyses, only age was found to be significantly associated to pathologically reduced minimum JSW (cut off value set at < or =2.0 mm), and the presence of osteophytes and subchondral cysts in both sexes (P ranging from 0.00 to 0.03). Minimum JSW < or =2.0 mm was recorded in 105 male hip joints, and in 167 female hip joints. In these joints, subchondral cysts, osteophytes and sclerosis were found to be significantly inter-related to minimum JSW < or =2.0 mm according to logistic regression analysis. The presence of subchondral cysts had the highest predictive sensitivity in regard to pathologically reduced minimum JSW compared to subchondral sclerosis and osteophytes.
We believe that an accurate radiologic case definition of hip OA will rest on a combination of features. Only studies of the distribution of features, singularly and in combination, applied to clinically evaluated large cohorts may provide the optimum answer to the best possible clinical case definition of hip OA.
本研究旨在探讨性别、年龄以及个体身体和职业因素对髋关节骨关节炎（OA）影像学特征分布的影响，并确定关节间隙宽度（JSW）减小这一主要影像学OA鉴别指标与继发性影像学OA特征之间的相互关系。
本研究为横断面调查。从3686名受试者（1397名男性/2289名女性）标准化的站立位骨盆X线片中记录髋关节OA的放射学特征。研究OA特征之间的相互关系以及与年龄、性别、体重指数（BMI）和重复性提举职业暴露的相关性。
总体而言，与女性髋关节相比，男性髋关节的软骨下硬化、囊肿和骨赘更为常见，而50岁以后，女性髋关节最小JSW随年龄的减小比男性更为明显且呈进行性。应用逻辑回归分析，仅发现年龄与病理性最小JSW减小（截断值设定为≤2.0 mm）以及男女两性骨赘和软骨下囊肿的存在显著相关（P值范围为0.00至0.03）。105个男性髋关节和167个女性髋关节记录到最小JSW≤2.0 mm。根据逻辑回归分析，在这些关节中，发现软骨下囊肿、骨赘和硬化与最小JSW≤2.0 mm显著相关。与软骨下硬化和骨赘相比，软骨下囊肿的存在对病理性最小JSW减小具有最高的预测敏感性。
我们认为，髋关节OA准确的放射学病例定义将依赖于多种特征的组合。只有对临床评估的大型队列单独或综合应用特征分布的研究，才能为髋关节OA最佳可能的临床病例定义提供最优答案。
