Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, USA.
Department of Radiology, University Hospital, LMU, Munich, Germany.
Eur Radiol. 2024 Jul;34(7):4321-4330. doi: 10.1007/s00330-023-10307-w. Epub 2024 Jan 3.
The goals of this study were (i) to assess the association between hip capsule morphology and pain in patients without any other MRI abnormalities that would correlate with pain and (ii) to investigate whether hip capsule morphology in hip pain patients is different from that of controls.
In this study, 76 adults with hip pain who did not show any structural abnormalities on MRI and 46 asymptomatic volunteers were included. Manual segmentation of the anterior and posterior hip capsules was performed. Total and mean anterior hip capsule area, posterior capsule area, anterior-to-posterior capsule area ratio, and medial-to-lateral area ratio in the anterior capsule were quantified. Differences between the pain and control groups were evaluated using logistic regression models.
Patients with hip pain showed a significantly lower anterior-to-posterior area ratio as compared with the control group (p = 0.002). The pain group's posterior hip capsule area was significantly larger than that of controls (p = 0.001). Additionally, the ratio between the medial and lateral sections of the anterior capsule was significantly lower in the pain group (p = 0.004).
Patients with hip pain are more likely to have thicker posterior capsules and a lower ratio of the anterior-to-posterior capsule area and thinner medial anterior capsules with a lower ratio of the medial-to-lateral anterior hip capsule compartment, compared with controls.
During MRI evaluations of patients with hip pain, morphology of the hip capsule should be assessed. This study aims to be a foundation for future analyses to identify thresholds distinguishing normal from abnormal hip capsule measurements.
• Even with modern image modalities such as MRI, one of the biggest challenges in handling hip pain patients is finding a structural link for their pain. • Hip capsule morphologies that correlated with hip pain showed a larger posterior hip capsule area and a lower anterior-to-posterior capsule area ratio, as well as a smaller medial anterior capsule area with a lower medial-to-lateral anterior hip capsule ratio. • The hip capsule morphology is correlated with hip pain in patients who do not show other morphology abnormalities in MRI and should get more attention in clinical practice.
本研究的目的是：（i）评估在没有任何其他与疼痛相关的 MRI 异常的情况下，髋关节囊形态与疼痛之间的关联；（ii）研究髋关节疼痛患者的髋关节囊形态是否与对照组不同。
本研究纳入了 76 例髋关节疼痛但 MRI 未见任何结构异常的成年人和 46 例无症状志愿者。对髋关节前囊和后囊进行手动分割。量化了前囊的总前囊面积、平均前囊面积、后囊面积、前囊前后面积比和前囊内外面积比。使用逻辑回归模型评估疼痛组与对照组之间的差异。
与对照组相比，髋关节疼痛患者的前囊前后面积比显著降低（p = 0.002）。疼痛组的后囊面积明显大于对照组（p = 0.001）。此外，疼痛组前囊内侧和外侧节段的比例明显较低（p = 0.004）。
与对照组相比，髋关节疼痛患者的后囊更厚，前囊前后面积比更低，前囊内侧更薄，前囊内外侧节段的比例更低。
在髋关节疼痛患者的 MRI 评估过程中，应评估髋关节囊的形态。本研究旨在为未来的分析奠定基础，以确定区分正常和异常髋关节囊测量的阈值。
即使有现代成像方式（如 MRI），处理髋关节疼痛患者的最大挑战之一是为他们的疼痛找到一个结构上的联系。与髋关节疼痛相关的髋关节囊形态表现为后囊面积增大、前囊前后面积比降低、前囊内侧面积减小、前囊内外侧节段比例降低。髋关节囊形态与 MRI 未见其他形态异常的髋关节疼痛患者相关，在临床实践中应得到更多关注。
