Radiology Department, UT Southwestern Medical Center, Dallas, TX, 75022, USA.
Orthopedics Department, UT Southwestern Medical Center, Dallas, TX, USA.
Skeletal Radiol. 2020 Jan;49(1):101-108. doi: 10.1007/s00256-019-03263-4. Epub 2019 Jun 28.
To analyze regional muscle CT density and bulk in femoroacetabular impingement (FAI) and hip dysplasia (HD) versus controls.
Patients who obtained perioperative CT imaging for FAI and HD before surgery were retrospectively studied. Asymptomatic controls included for comparison. Two readers independently evaluated regional hip muscle [iliopsoas (IP), rectus femoris (RF), gluteus minimus (Gm), and medius (GM)] density, muscle area, and muscle circumference. Inter-observer reliability calculated using intra-class correlation coefficient (ICC).
A consecutive series of 25 FAI patients, 16 HD patients, and 38 controls were recruited in the study. FAI patients had significantly greater Gm and GM circumferences as well as greater RF and IP areas on the normal side compared to the asymptomatic control group (p values 0.004, 0.032, 0.033, and 0.028, respectively). In addition, Gm and RF circumferences and RF area were significantly larger (p values 0.029, 0.036, and 0.014, respectively) in FAI patients on the affected side compared to the control group. HD patients had significantly smaller Gm and GM circumferences on the affected side than normal side measurements in FAI group (p values 0.043 and 0.003, respectively). Normal side GM circumference was also smaller in HD patients than normal side FAI hips (p value 0.02). There was no significant difference between the measurements on normal and abnormal sides in each disease group. No significant difference was found between measurements of HD compared to controls (p > 0.05). No muscle density differences were seen among different groups. There was moderate to excellent inter-reader reliability for all measurements except Gm muscle density.
Muscle analysis was able to quantify differences among patients with FAI, HD, and asymptomatic controls. These changes could indicate either a muscle imbalance contributing to the pathology or disuse atrophy, which may have implications for specific muscle-strengthening therapies and rehabilitation procedures in such patients.
分析髋关节撞击综合征（FAI）和髋关节发育不良（HD）患者的髋关节区域肌肉 CT 密度和体积与对照组的差异。
对接受髋关节 FAI 和 HD 手术的患者进行回顾性研究，纳入术前接受 CT 成像的患者作为研究对象。同时纳入无症状对照组进行比较。两位读者独立评估髋关节区域肌肉（髂腰肌（IP）、股直肌（RF）、臀小肌（Gm）和臀中肌（GM））密度、肌肉面积和肌肉周长。采用组内相关系数（ICC）评估观察者间的可靠性。
本研究共纳入 25 例 FAI 患者、16 例 HD 患者和 38 例对照组。FAI 患者的患侧 Gm 和 GM 周长以及健侧 RF 和 IP 面积明显大于无症状对照组（p 值分别为 0.004、0.032、0.033 和 0.028）。此外，与对照组相比，FAI 患者患侧的 Gm 和 RF 周长和 RF 面积也明显更大（p 值分别为 0.029、0.036 和 0.014）。与 FAI 组的健侧相比，HD 患者患侧的 Gm 和 GM 周长明显更小（p 值分别为 0.043 和 0.003）。HD 患者的健侧 GM 周长也明显小于 FAI 健侧（p 值为 0.02）。在每个疾病组中，正常侧和异常侧的测量值之间没有显著差异。与对照组相比，HD 患者的测量值之间没有差异（p>0.05）。不同组之间的肌肉密度没有差异。除 Gm 肌肉密度外，所有测量值的观察者间可靠性均为中度至高度可靠。
肌肉分析能够定量评估 FAI、HD 和无症状对照组患者之间的差异。这些变化可能表明存在导致疾病的肌肉失衡或废用性萎缩，这可能对这些患者的特定肌肉强化治疗和康复程序具有重要意义。
