Department of Rheumatology, CHRU de Nancy, 5, rue du Morvan, 54500 Vandœuvre-lès-Nancy, France.
Department of Rheumatology, North Hospital Franche-Comté, 25200 Montbéliard, France.
Joint Bone Spine. 2018 Jul;85(4):475-480. doi: 10.1016/j.jbspin.2017.08.004. Epub 2017 Sep 8.
To assess predictors of response, according to hip MRI inflammatory scoring system (HIMRISS), in a sample of patients with hip osteoarthritis (OA) treated by hyaluronic acid (HA) injection.
Sixty patients with hip OA were included. Clinical outcomes were assessed at baseline and three months after HA injection by WOMAC. On hip MRI performed before HA injection, bone marrow lesion (BML) and synovitis were assessed by HIMRISS by four readers. The inter-reader reliability of HIMRISS was for HIMRISS total, acetabular BML, femoral BML and synovitis-effusion respectively 0.86, 0.64, 0.83 and 0.78. Associations between MRI features and clinical data were assessed. Logistic regression (univariate and multivariate) was used to explore associations between MRI features and response to HA injection, according to WOMAC50 response at three months.
In total, 45.5% of patients met WOMAC50 response. Five adverse events were reported. At baseline, WOMAC function correlated significantly to HIMRISS synovitis-effusion (r=0.27, P=0.03). In univariate analysis, BML femoral according to binary assessment (P=0.025), HIMRISS BML femoral (P=0.0038), HIMRISS BML acetabular (P=0.042), HIMRISS total (P=0.0092) were associated negatively with WOMAC50 response. In multivariate analysis, adjusted for age and BMI, HIMRISS femoral BML (P=0.02) and HIMRISS total (P=0.016) were negatively associated with response. At a HIMRISS threshold of<15, 82% of patients were responders, with specificity SP=0.97, sensitivity SN=0.39, and positive and negative predictive values of 0.91 and 0.64, respectively.
HIMRISS is reliable for total scores and sub-domains. It permits identification of responders to HA injection in hip OA patients.
根据髋关节磁共振成像炎症评分系统（HIMRISS）评估接受透明质酸（HA）注射治疗的髋关节骨关节炎（OA）患者的反应预测因素。
纳入 60 例髋关节 OA 患者。在 HA 注射前、后 3 个月，通过 WOMAC 评估临床结局。在 HA 注射前进行的髋关节 MRI 上，通过 HIMRISS 由 4 位读者评估骨髓病变（BML）和滑膜炎。HIMRISS 总评分、髋臼 BML、股骨 BML 和滑膜炎-积液的读者间可靠性分别为 0.86、0.64、0.83 和 0.78。评估 MRI 特征与临床数据之间的相关性。使用逻辑回归（单变量和多变量）根据 WOMAC50 在 3 个月时的反应，探讨 MRI 特征与 HA 注射反应之间的关系。
共有 45.5%的患者达到 WOMAC50 反应。报告了 5 例不良事件。在基线时，WOMAC 功能与 HIMRISS 滑膜炎-积液显著相关（r=0.27，P=0.03）。在单变量分析中，根据二进制评估的股骨 BML（P=0.025）、HIMRISS 股骨 BML（P=0.0038）、HIMRISS 髋臼 BML（P=0.042）、HIMRISS 总评分（P=0.0092）与 WOMAC50 反应呈负相关。在多变量分析中，调整年龄和 BMI 后，HIMRISS 股骨 BML（P=0.02）和 HIMRISS 总评分（P=0.016）与反应呈负相关。在 HIMRISS 阈值<15 时，82%的患者为反应者，特异性 SP=0.97，敏感性 SN=0.39，阳性和阴性预测值分别为 0.91 和 0.64。
HIMRISS 总分和各亚域均可靠。它可以识别接受透明质酸注射治疗的髋关节 OA 患者的反应者。
