Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China.
Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000, Australia.
Rheumatol Int. 2024 Oct;44(10):1887-1896. doi: 10.1007/s00296-024-05678-2. Epub 2024 Aug 13.
Magnetic resonance imaging (MRI) is increasingly used in the classification and evaluation of osteoarthritis (OA). Many studies have focused on knee OA, investigating the association between MRI-detected knee structural abnormalities and knee pain. Hip OA differs from knee OA in many aspects, but little is known about the role of hip structural abnormalities in hip pain. This study aimed to systematically evaluate the association of hip abnormalities on MRI, such as cartilage defects, bone marrow lesions (BMLs), osteophytes, paralabral cysts, effusion-synovitis, and subchondral cysts, with hip pain. We searched electronic databases from inception to February 2024, to identify publications that reported data on the association between MRI features in the hip joint and hip pain. The quality of the included studies was scored using the Newcastle-Ottawa Scale (NOS). The levels of evidence were evaluated according to the Cochrane Back Review Group Method Guidelines and classified into five levels: strong, moderate, limited, conflicting, and no evidence. A total of nine studies were included, comprising five cohort studies, three cross-sectional studies, and one case-control study. Moderate level of evidence suggested a positive association of the presence and change of BMLs with the severity and progress of hip pain, and evidence for the associations between other MRI features and hip pain were limited or even conflicting. Only a few studies with small to modest sample sizes evaluated the association between hip structural changes on MRI and hip pain. BMLs may contribute to the severity and progression of hip pain. Further studies are warranted to uncover the role of hip MRI abnormalities in hip pain. The protocol for the systematic review was registered with PROSPERO ( https://www.crd.york.ac.uk/PROSPERO/ , CRD42023401233).
磁共振成像（MRI）越来越多地用于骨关节炎（OA）的分类和评估。许多研究都集中在膝关节 OA 上，研究了 MRI 检测到的膝关节结构异常与膝关节疼痛之间的关系。髋关节 OA 在许多方面与膝关节 OA 不同，但髋关节结构异常在髋关节疼痛中的作用知之甚少。本研究旨在系统评估 MRI 上髋关节的异常，如软骨缺损、骨髓病变（BMLs）、骨赘、盂唇旁囊肿、关节积液-滑膜炎和软骨下囊肿，与髋关节疼痛之间的关系。我们从成立到 2024 年 2 月，在电子数据库中搜索了报告髋关节 MRI 特征与髋关节疼痛之间关系的数据的出版物。使用纽卡斯尔-渥太华量表（NOS）对纳入研究的质量进行评分。根据 Cochrane 背部审查组方法指南评估证据水平，并分为五个等级：强、中、有限、矛盾和无证据。共纳入 9 项研究，包括 5 项队列研究、3 项横断面研究和 1 项病例对照研究。中等水平的证据表明，BMLs 的存在和变化与髋关节疼痛的严重程度和进展呈正相关，而其他 MRI 特征与髋关节疼痛之间的关联证据有限甚至存在矛盾。只有少数小样本量的研究评估了 MRI 上髋关节结构变化与髋关节疼痛之间的关系。BMLs 可能导致髋关节疼痛的严重程度和进展。需要进一步的研究来揭示髋关节 MRI 异常在髋关节疼痛中的作用。本系统评价的方案已在 PROSPERO（https://www.crd.york.ac.uk/PROSPERO/，CRD42023401233）上注册。
