Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, Southmead Hospital, Bristol BS10 5NB, UK.
Arthritis and Musculoskeletal Medicine, Institute of Medical Sciences, University of Aberdeen, AB25 2ZD, UK.
Osteoarthritis Cartilage. 2017 Dec;25(12):2031-2038. doi: 10.1016/j.joca.2017.09.006. Epub 2017 Sep 21.
Statistical shape modelling (SSM) of radiographs has been used to explore relationships between altered joint shape and hip osteoarthritis (OA). We aimed to apply SSM to Dual-energy X-ray Absorptiometry (DXA) hip scans, and examine associations between resultant hip shape modes (HSMs), radiographic hip OA (RHOA), and hip pain, in a large population based cohort.
SSM was performed on baseline hip DXA scans from the Osteoporotic Fractures in Men (MrOS) Study. Associations between the top ten HSMs, and prevalent RHOA from pelvic radiographs obtained 4.6 years later, were analysed in 4100 participants. RHOA was defined as Croft score ≥2. Hip pain was based on pain on walking, hip pain on examination, and Western Ontario and McMaster Universities Arthritis Index (WOMAC).
The five HSMs associated with RHOA showed features of either pincer- or cam-type deformities. HSM 1 (increased pincer-type deformity) was positively associated with RHOA [1.23 (1.09, 1.39)] [odds ratio (OR) and 95% CI]. HSM 8 (reduced pincer-type deformity) was inversely associated with RHOA [0.79 (0.70, 0.89)]. HSM 10 (increased cam-type deformity) was positively associated with RHOA [1.21 (1.07, 1.37)]. HSM 3 and HSM 4 (reduced cam-type deformity) were inversely associated with RHOA [0.73 (0.65, 0.83) and 0.82 (0.73, 0.93), respectively]. HSM 3 was inversely related to pain on examination [0.84 (0.76, 0.92)] and walking [0.88, (0.81, 0.95)], and to WOMAC score [0.87 (0.80, 0.93)].
DXA-derived measures of hip shape are associated with RHOA, and to a lesser extent hip pain, possibly reflecting their role in the pathogenesis of hip OA.
放射学的统计形状建模（SSM）已被用于探索关节形状改变与髋关节炎（OA）之间的关系。我们旨在将 SSM 应用于双能 X 射线吸收测定法（DXA）髋部扫描，并在大型基于人群的队列中检查由此产生的髋部形状模式（HSM）与放射学髋 OA（RHOA）和髋部疼痛之间的关联。
在 Osteoporotic Fractures in Men（MrOS）研究的基线髋部 DXA 扫描中进行 SSM。在 4100 名参与者中，分析了与骨盆 X 射线检查 4.6 年后获得的流行 RHOA 相关的前 10 个 HSM 与 DXA 髋关节扫描之间的关系。RHOA 的定义为 Croft 评分≥2。髋部疼痛是基于行走时的疼痛，髋部检查时的疼痛和 Western Ontario 和 McMaster 大学关节炎指数（WOMAC）。
与 RHOA 相关的五个 HSM 显示出钳形或凸轮畸形的特征。HSM 1（增加的钳形畸形）与 RHOA 呈正相关[1.23（1.09，1.39）][比值比（OR）和 95％置信区间]。HSM 8（减少的钳形畸形）与 RHOA 呈负相关[0.79（0.70，0.89）]。HSM 10（增加的凸轮畸形）与 RHOA 呈正相关[1.21（1.07，1.37）]。HSM 3 和 HSM 4（减少的凸轮畸形）与 RHOA 呈负相关[0.73（0.65，0.83）和 0.82（0.73，0.93）]。HSM 3 与检查时的疼痛[0.84（0.76，0.92）]和行走时的疼痛[0.88（0.81，0.95）]和 WOMAC 评分[0.87（0.80，0.93）]呈负相关。
髋部形状的 DXA 衍生测量值与 RHOA 相关，与髋部疼痛的关联程度较小，这可能反映了它们在髋 OA 发病机制中的作用。
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