Bakhsh Wajeeh, Childs Sean, Kenney Raymond, Schiffman Scott, Giordano Brian
Department of Orthopaedics, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY, 14642, USA.
Department of Radiology, University of Rochester Medical Center, Rochester, NY, USA.
Skeletal Radiol. 2019 Jun;48(6):889-896. doi: 10.1007/s00256-018-3083-5. Epub 2018 Oct 2.
To illustrate an advanced imaging parameter that describes the course of the iliopsoas tendon, and evaluate its correlations with iliopsoas internal hip snapping syndrome.
This retrospective cohort study reviewed hip MRI images of all patients seen by a single surgeon between January 2015 and March 2016. The comparison group included all patients with clinical internal hip snapping, versus the control group that did not. MRI images were processed using minimum intensity projection. Measurements obtained of the pelvis and course of the iliopsoas tendon included: pelvic incidence, coronal angle, and sagittal opening angle (SOA). Comparison of measurements between the groups was performed with Mann-Whitney U analysis and receiver operator curve (ROC) plotting, with a significance cutoff of p = 0.05.
The control group (n = 85) and comparison group (n = 48) demonstrated no difference in age or gender. Pelvic incidence was similar [51.3 (± 10.7) degrees control versus 52.2 (± 7.7) degrees comparison (p = 0.36)], as was coronal angle [13.9 (± 4.6) degrees control versus 14.8 (±4.8) degrees comparison (p = 0.15)]. There was a significant difference in SOA [137.0 (± 5.9) degrees control versus 141.9 (± 6.5) degrees comparison (p < 0.01)]. ROC analysis revealed SOA threshold of 140 degrees for clinical IP hip snapping (p < 0.01), with odds ratio 5.2 (2.4-11.3) for SOA > 140 degrees.
Iliopsoas hip snapping is often part of a more complex disease process. While challenging to diagnose, advanced imaging parameters, like the sagittal opening angle, relate with clinical pathology. The SOA offers diagnostic value, with a threshold of greater than 140 degrees significantly correlating with clinical presentation.
阐述一种描述髂腰肌肌腱走行的先进成像参数，并评估其与髂腰肌型髋关节内弹响综合征的相关性。
这项回顾性队列研究回顾了2015年1月至2016年3月间由一位外科医生诊治的所有患者的髋关节MRI图像。比较组包括所有有临床髋关节内弹响的患者，对照组为无此症状的患者。MRI图像采用最小强度投影法进行处理。对骨盆和髂腰肌肌腱走行的测量包括：骨盆倾斜角、冠状角和矢状开口角（SOA）。采用Mann-Whitney U分析和受试者操作特征曲线（ROC）绘图对两组测量值进行比较，显著性临界值为p = 0.05。
对照组（n = 85）和比较组（n = 48）在年龄或性别上无差异。骨盆倾斜角相似[对照组为51.3（±10.7）度，比较组为52.2（±7.7）度（p = 0.36）]，冠状角也相似[对照组为13.9（±4.6）度，比较组为14.8（±4.8）度（p = 0.15）]。SOA有显著差异[对照组为137.0（±5.9）度，比较组为141.9（±6.5）度（p < 0.01）]。ROC分析显示，临床髂腰肌型髋关节内弹响的SOA阈值为140度（p < 0.01），SOA > 140度的优势比为5.2（2.4 - 11.3）。
髂腰肌型髋关节内弹响通常是更复杂疾病过程的一部分。虽然诊断具有挑战性，但先进的成像参数，如矢状开口角，与临床病理相关。SOA具有诊断价值，大于140度的阈值与临床表现显著相关。
