do Amaral E Castro Adham, Miranda Frederico Celestino, Fukamizu Erina Megumi Nagaya, Yoshimura Fabio Brandão, Baptista Eduardo, de Paula Silva Camila, Otoni Jessyca Couto, do Carmo Barros Santos Durval, Rosemberg Laercio Alberto, Taneja Atul Kumar
Imaging Department, Hospital Israelita Albert Einstein, Av. Albert Einstein, São Paulo, Brazil.
Department of Diagnostic Imaging, Universidade Federal de São Paulo, São Paulo, Brazil.
Skeletal Radiol. 2025 Aug 23. doi: 10.1007/s00256-025-05016-y.
To determine whether MRI can differentiate hips with nonspecific inflammatory conditions from controls based on measurements of the capsule and to identify the most significant measurements.
In this retrospective and case-control study, we reviewed hip MRIs containing the term "capsulitis" in the reports. Cases with other known diagnoses or confounding joint pathologies were excluded. Controls were asymptomatic hips with normal laboratory results. Three musculoskeletal radiologists independently reviewed the studies, assessing for qualitative (edema, enhancement, effusion, synovitis, and subjective thickening) and quantitative (capsular thickness in standardized planes) parameters. Interobserver agreement, group comparisons, and optimal cutoffs were analyzed.
The final study group comprised 38 cases, and the control group included 51 matched subjects. Inter-reader agreement was moderate to excellent. For capsular thickness, ICC ranged from 0.49 (posterior sagittal) to 0.87 (anterior sagittal). For qualitative findings, kappa ranged from 0.59 (capsular enhancement) to 0.84 (joint effusion), the greatest being capsular thickening and effusion. All planes showed significantly larger capsular thickness in cases vs. controls (p < 0.05). Sensitivity reached 85.2% for anterior sagittal measurement (mean, 6.27 vs. 4.58 mm), and specificity reached 84% for lateral coronal (6.53 vs. 4.13 mm). Among cases, capsular signal abnormality was observed in 89.2% of cases, pericapsular edema in 91.9%, capsular enhancement in 97.3%, pericapsular enhancement in 94.6%, joint effusion in 81.1%, synovitis in 89.2%, and capsular thickening in 100% of cases.
Our study reveals increased hip capsular thickness in nonspecific inflammatory conditions of the hip (capsulitis), both for qualitative and quantitative assessments.
基于关节囊测量来确定MRI能否区分患有非特异性炎症的髋关节与对照组，并找出最具显著意义的测量指标。
在这项回顾性病例对照研究中，我们查阅了报告中包含“关节囊炎”一词的髋关节MRI。排除有其他已知诊断或混淆关节病变的病例。对照组为实验室检查结果正常的无症状髋关节。三位肌肉骨骼放射科医生独立评估这些研究，评估定性（水肿、强化、积液、滑膜炎和主观增厚）和定量（标准化平面的关节囊厚度）参数。分析了观察者间的一致性、组间比较和最佳截断值。
最终研究组包括38例病例，对照组包括51例匹配的受试者。读者间的一致性从中度到优。对于关节囊厚度，组内相关系数（ICC）范围从0.49（矢状面后部）到0.87（矢状面前部）。对于定性结果，kappa值范围从0.59（关节囊强化）到0.84（关节积液），最大的是关节囊增厚和积液。所有平面显示病例组的关节囊厚度显著大于对照组（p < 0.05）。矢状面前部测量的敏感性达到85.2%（平均值，6.27对4.58毫米），冠状面外侧测量的特异性达到84%（6.53对4.13毫米）。在病例组中，89.2%的病例观察到关节囊信号异常，91.9%有囊周水肿，97.3%有关节囊强化，94.6%有囊周强化，81.1%有关节积液，89.2%有滑膜炎，100%有关节囊增厚。
我们的研究表明，在髋关节非特异性炎症（关节囊炎）中，无论是定性还是定量评估，髋关节囊厚度均增加。
