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软骨缺损及其他 MRI 表现与轻中度放射学髋关节骨关节炎患者及对照组疼痛和功能的相关性。

Association of cartilage defects, and other MRI findings with pain and function in individuals with mild-moderate radiographic hip osteoarthritis and controls.

机构信息

Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA.

出版信息

Osteoarthritis Cartilage. 2013 Nov;21(11):1685-92. doi: 10.1016/j.joca.2013.08.009. Epub 2013 Aug 12.

Abstract

OBJECTIVE

To evaluate the relationship of hip radiographic osteoarthritis (ROA) and MRI findings of cartilage lesions, labral tears, bone marrow edema-like lesions (BMELs) and subchondral cysts with self-reported and physical function.

DESIGN

Eighty five subjects were classified as controls (n = 55, Kellgren-Lawrence (KL) 0, 1) or having mild-moderate ROA (n = 30, KL 2, 3). T2 weighted MRI images at 3-T were graded for presence of cartilage lesions, labral tears, BMELs and subchondral cysts. Posterior wall sign, cross-over sign, center-edge angle and alpha angle were also recorded. Function was assessed using Hip dysfunction and Osteoarthritis Outcome Score (HOOS), Timed-Up and Go (TUG) test and Y-Balance Test (YBT). Analysis compared function between subjects with and without ROA and those with and without femoral or acetabular cartilage lesions, adjusted for age. Non-parametric correlations were used to assess the relationship between radiographic scores, MRI scores and function.

RESULTS

Subjects with acetabular cartilage lesions had worse HOOS (Difference = 5-10%, P = 0.036-0.004), but not TUG or YBT, scores. Acetabular cartilage lesions, BMELs and subchondral cysts were associated with worse HOOS scores (ρ = 0.23-0.37, P = 0.041-0.001). Differences in function between subjects with and without ROA or femoral cartilage lesions were not significant. Other radiologic findings were not associated with function.

CONCLUSIONS

Acetabular cartilage defects, but not femoral cartilage defects or ROA, were associated with greater self-reported pain and disability. BMELs and subchondral cysts were related to greater hip related self-reported pain and disability. None of the radiographic or MRI features was related to physical function.

摘要

目的

评估髋关节放射学骨关节炎(ROA)与软骨病变、盂唇撕裂、骨髓水肿样病变(BMELs)和软骨下囊肿的 MRI 表现与自报告功能和身体功能的关系。

设计

85 名受试者分为对照组(n=55,Kellgren-Lawrence(KL)0、1)或轻度至中度 ROA 组(n=30,KL 2、3)。在 3T 磁共振成像上对 T2 加权图像进行分级,以评估软骨病变、盂唇撕裂、BMELs 和软骨下囊肿的存在。还记录了后壁征、交叉征、中心边缘角和α角。使用髋关节功能和骨关节炎结果评分(HOOS)、计时起立行走测试(TUG)和 Y 型平衡测试(YBT)评估功能。分析比较了 ROA 患者与非 ROA 患者以及股骨或髋臼软骨病变患者与非软骨病变患者之间的功能,并根据年龄进行了调整。采用非参数相关分析评估放射学评分、MRI 评分与功能之间的关系。

结果

髋臼软骨病变患者的 HOOS 评分较差(差异=5-10%,P=0.036-0.004),但 TUG 或 YBT 评分无差异。髋臼软骨病变、BMELs 和软骨下囊肿与较差的 HOOS 评分相关(ρ=0.23-0.37,P=0.041-0.001)。ROA 或股骨软骨病变患者之间的功能差异无统计学意义。其他放射学发现与功能无关。

结论

髋臼软骨缺损,但不是股骨软骨缺损或 ROA,与更大的自报告疼痛和残疾相关。BMELs 和软骨下囊肿与髋关节相关的自报告疼痛和残疾增加有关。放射学或 MRI 特征均与身体功能无关。

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