Dougados M, Gueguen A, Nguyen M, Berdah L, Lequesne M, Mazières B, Vignon E
Rheumatology Department, Cochin Teaching Hospital, Paris, France.
Rev Rhum Engl Ed. 1997 Dec;64(12):795-803.
To evaluate potential radiographic predictors of hip osteoarthritis progression.
A prospective, longitudinal two-year study was conducted in patients meeting American College of Rheumatology criteria for hip osteoarthritis. Hip osteoarthritis progression was defined as a greater than 0.5-mm decrease in joint space width measured using a magnifying glass marked at intervals of 0.1 mm, at the site of maximum joint space narrowing, by a single investigator who was blinded to the chronological order of the radiographs. Radiographic parameters determined at study entry were as follows: presence of osteophytes, osteosclerosis, and subchondral cysts; femoral head migration (superolateral, superomedial, concentric); and severity (joint space width in mm, Kellgren and Lawrence grade, subjective evaluation of joint space narrowing).
In the 463 study patients, joint space width decreased from 2.2 +/- 0.8 at baseline to 1.7 +/- 1.0 mm after two years (P < 0.0001). Radiographic progression was seen in 148 patients (32%). Radiologic parameters predictive of disease progression in the multivariate analyses were as follows:
Our data suggest that a number of baseline radiological features including distribution of joint space loss, subchondral bone production, and severity of joint space loss are predictive of progression of hip osteoarthritis.
评估髋骨关节炎进展的潜在影像学预测指标。
对符合美国风湿病学会髋骨关节炎标准的患者进行了一项为期两年的前瞻性纵向研究。髋骨关节炎进展定义为在最大关节间隙变窄部位,由一名对X线片时间顺序不知情的研究者,使用间隔0.1毫米标记的放大镜测量关节间隙宽度减少超过0.5毫米。研究开始时确定的影像学参数如下:骨赘、骨质硬化和软骨下囊肿的存在情况;股骨头移位(上外侧、上内侧、同心);以及严重程度(以毫米为单位的关节间隙宽度、凯尔格伦和劳伦斯分级、关节间隙变窄的主观评估)。
在463例研究患者中,关节间隙宽度从基线时的2.2±0.8毫米降至两年后的1.7±1.0毫米(P<0.0001)。148例患者(32%)出现影像学进展。多变量分析中预测疾病进展的放射学参数如下:
我们的数据表明,包括关节间隙丢失分布、软骨下骨生成以及关节间隙丢失严重程度在内的一些基线放射学特征可预测髋骨关节炎的进展。