Jones Carly E, Mulpuri Kishore, Teo Tammie, Wilson David R, d'Entremont Agnes G
Centre for Hip Health and Mobility.
School of Biomedical Engineering, University of British Columbia.
J Pediatr Orthop B. 2022 Jul 1;31(4):344-349. doi: 10.1097/BPB.0000000000000892. Epub 2021 Jun 18.
Legg-Calvé-Perthes disease (LCPD) is a juvenile hip disorder associated with residual femoral head deformity, cartilage degeneration and a high risk of early onset hip osteoarthritis. Assessing management of LCPD in the healed phase requires an understanding of when and where hip cartilage damage happens. While it has been shown that cartilage is degenerated in healed LCPD hips in adults, it is not clear when this degeneration begins. Our research question was: Are the MR markers of cartilage degeneration T1ρ and T2 increased in healed LCPD hips in adolescents? Twelve adolescents [10-17 years old (mean 14); 3 female 9 male] with healed LCPD (Stulberg 2-5; 8 unilateral and 4 bilateral) and 15 age- and sex-matched controls were imaged in a 3T MRI using a T1ρ and a T2 sequence. We applied a mixed-effects model adjusted for age and nested by subject to determine the effect of Stulberg grade on overall and regional mean T1ρ and T2 values. T1ρ was significantly higher overall and in the medial region of Stulberg ≥3 hips, and in the medial region of Stulberg 2 hips than in the control group. T2 was significantly higher in the medial region of Stulberg ≥3 hips than in the control group. Our results suggest that cartilage damage in LCPD has begun by adolescence and that T1ρ can detect early changes in cartilage associated with LCPD.
Legg-Calvé-Perthes病（LCPD）是一种青少年髋关节疾病，与股骨头残留畸形、软骨退变以及早期发生髋关节骨关节炎的高风险相关。评估LCPD愈合期的治疗需要了解髋关节软骨损伤发生的时间和部位。虽然已表明成人LCPD愈合的髋关节中软骨会发生退变，但尚不清楚这种退变何时开始。我们的研究问题是：青少年LCPD愈合的髋关节中，软骨退变的磁共振成像（MR）标志物T1ρ和T2是否升高？对12名LCPD已愈合的青少年[10 - 17岁（平均14岁）；3名女性，9名男性]（Stulberg分级2 - 5级；8例单侧，4例双侧）和15名年龄及性别匹配的对照组进行3T磁共振成像，采用T1ρ和T2序列。我们应用了一个针对年龄进行调整并按受试者进行嵌套的混合效应模型，以确定Stulberg分级对整体及区域平均T1ρ和T2值的影响。总体而言，Stulberg≥3级髋关节以及Stulberg 2级髋关节的内侧区域的T1ρ显著高于对照组。Stulberg≥3级髋关节的内侧区域的T2显著高于对照组。我们的结果表明，LCPD中的软骨损伤在青少年期就已开始，并且T1ρ可以检测到与LCPD相关的软骨早期变化。
