Tso Chi Kin Nathan, O'Sullivan Richard, Khan Hussain, Fitzpatrick Jane
Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia.
Department of Medicine, Monash University, Melbourne, Australia.
Orthop J Sports Med. 2021 Apr 22;9(4):2325967121998389. doi: 10.1177/2325967121998389. eCollection 2021 Apr.
Gluteal tendinopathy is commonly reported in the literature, but there is a need for a validated magnetic resonance imaging (MRI)-based scoring system to grade the severity of the tendinopathy.
To use intra- and interobserver reliability to validate a new scoring system, the Melbourne Hip MRI (MHIP) score, for assessing the severity of gluteal tendinopathy.
Cohort study (diagnosis); Level of evidence, 3.
The MHIP score assesses gluteal tendinopathy according to each 1 of 5 categories: (1) extent of tendon pathology (maximum 5 points); (2) muscle atrophy (maximum 4 points); (3) trochanteric bursitis (maximum 4 points); (4) cortical irregularity (maximum 3 points); and (5) bone marrow edema (maximum 1 point), with an overall range of 0 to 17 (most severe). A total of 41 deidentified MRI scans from 40 patients diagnosed with gluteal tendinopathy (mean baseline age, 57.44 ± 25.26 years; 4 male, 36 female) were read and graded according to MHIP criteria by 2 experienced musculoskeletal radiologists. The radiologists were blinded to previous reports, and the scans were read twice within a 2-month period. Statistical analysis using the intraclass correlation coefficient (ICC) was used to determine intra- and interobserver reliability and mean/range for the MHIP scores.
Of a total of 123 readings, the mean MHIP score (±SD) was 3.93 ± 2.24 (range, 0-17 points). The MHIP score demonstrated excellent reliability for determining the severity of gluteal tendinopathy on MRI. The ICC for intra- and interobserver reliability was 0.81 (95% CI, 0.67-0.89) and 0.78 (95% CI, 0.62-0.87), respectively.
The MHIP score had excellent intra- and interobserver reliability in scoring gluteal tendinopathy. This score allows gluteal tendon pathology to be graded prior to treatment and to be used for standardized comparisons between results in future research undertaking radiological review of gluteal tendinopathy.
臀肌肌腱病在文献中常有报道，但需要一种经过验证的基于磁共振成像（MRI）的评分系统来对肌腱病的严重程度进行分级。
利用观察者内和观察者间的可靠性来验证一种新的评分系统——墨尔本髋关节MRI（MHIP）评分，以评估臀肌肌腱病的严重程度。
队列研究（诊断）；证据等级，3级。
MHIP评分根据以下5个类别中的每一项来评估臀肌肌腱病：（1）肌腱病变范围（最高5分）；（2）肌肉萎缩（最高4分）；（3）转子滑囊炎（最高4分）；（4）皮质不规则（最高3分）；以及（5）骨髓水肿（最高1分），总分范围为0至17分（最严重）。对40例诊断为臀肌肌腱病患者（平均基线年龄57.44±25.26岁；男性4例，女性36例）的41份匿名MRI扫描图像，由2名经验丰富的肌肉骨骼放射科医生根据MHIP标准进行阅片和分级。放射科医生对既往报告不知情，扫描图像在2个月内进行了两次阅片。使用组内相关系数（ICC）进行统计分析，以确定观察者内和观察者间的可靠性以及MHIP评分的均值/范围。
在总共123次阅片中，MHIP评分的均值（±标准差）为3.93±2.24（范围0 - 17分）。MHIP评分在确定MRI上臀肌肌腱病的严重程度方面显示出极好的可靠性。观察者内和观察者间可靠性的ICC分别为0.81（95%CI，0.67 - 0.89）和0.78（95%CI，0.62 - 0.87）。
MHIP评分在对臀肌肌腱病进行评分时具有极好的观察者内和观察者间可靠性。该评分能够在治疗前对臀肌肌腱病变进行分级，并用于未来对臀肌肌腱病进行放射学评估的研究结果之间的标准化比较。
