Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
European Radiology
Published in: European Radiology 2/2019

01-02-2019 | Musculoskeletal

Validation of scoring hip osteoarthritis with MRI (SHOMRI) scores using hip arthroscopy as a standard of reference

Authors: Jan Neumann, Alan L. Zhang, Benedikt J. Schwaiger, Michael A. Samaan, Richard Souza, Sarah C. Foreman, Gabby B. Joseph, Trevor Grace, Sharmila Majumdar, Thomas M. Link

Published in: European Radiology | Issue 2/2019

Login to get access

Abstract

Purpose

To validate SHOMRI gradings in preoperative hip magnetic resonance imaging (MRI) with intra-arthroscopic evaluation of intraarticular hip abnormalities.

Methods

Preoperative non-arthrographic 3.0-T MRIs of 40 hips in 39 patients (1 patient with bilateral hip surgery) with femoroacetabular impingement (FAI) syndrome (mean age, 34.7 years ± 9.0; n = 16 females), refractory to conservative measures, that underwent hip arthroscopy were retrospectively assessed by two radiologists for chondrolabral abnormalities and compared with intra-arthroscopic findings as the standard of reference. Arthroscopically accessible regions were compared with the corresponding SHOMRI subregions and assessed for the presence and grade of cartilaginous pathologies in the acetabulum and femoral head. The acetabular labrum was assessed for the presence or absence of labral tears. For the statistical analysis sensitivity and specificity as well as intraclass correlation (ICC) for interobserver agreement were calculated.

Results

Regarding chondral abnormalities, 58.8% of the surgical cases showed chondral defects. SHOMRI scoring showed a sensitivity of 95.7% and specificity of 84.8% in detecting cartilage lesions. Moreover, all cases with full-thickness defects (n = 9) were identified correctly, and in n = 6 cases (out of n = 36 with partial-thickness defects) the defective cartilage was identified but the actual depth overestimated. Labral tears were present in all cases and the MR readers identified 92.5% correctly. ICC showed a good interobserver agreement with 86.3% (95% CI 80.0, 90.6%)

Conclusion

Using arthroscopic correlation, SHOMRI grading of the hip proves to be a reliable and precise method to assess chondrolabral hip joint abnormalities.

Key Points

• Assessment of hip abnormalities using MRI with surgical correlation.
• Comparing surgery and MRI by creating a hybrid anatomic map that covers both modalities.
• Non-arthrographic use of 3.0-T MRI provides detailed information on cartilage and labral abnormalities in hip joints.
Literature
1.
2.
Turkiewicz A, Petersson IF, Björk J et al (2014) Current and future impact of osteoarthritis on health care: a population-based study with projections to year 2032. Osteoarthritis Cartilage 22(11):1826–1832CrossRef
3.
Yusuf E (2016) Pharmacologic and non-pharmacologic treatment of osteoarthritis. Curr Treat Options Rheumatol 2(2):111–125CrossRef
4.
Karsdal MA, Michaelis M, Ladel C et al (2016) Disease-modifying treatments for osteoarthritis (DMOADs) of the knee and hip: lessons learned from failures and opportunities for the future. Osteoarthritis Cartilage 24(12):2013–2021CrossRef
5.
Vita AJ, Terry RB, Hubert HB, Fries JF (1998) Aging, health risks, and cumulative disability. N Engl J Med 338(15):1035–1041CrossRef
6.
Peffers MJ, Balaskas P, Smagul A (2018) Osteoarthritis year in review 2017: genetics and epigenetics. Osteoarthritis Cartilage 26(3):304–311CrossRef
7.
Felson DT, Lawrence RC, Dieppe PA et al (2000) Osteoarthritis: new insights. Part 1: the disease and its risk factors. Ann Intern Med 133(8):635–646CrossRef
8.
Quintana JM, Arostegui I, Escobar A et al (2008) Prevalence of knee and hip osteoarthritis and the appropriateness of joint replacement in an older population. Arch Intern Med 168(14):1576–1584CrossRef
9.
Agricola R, Waarsing JH, Arden NK et al (2013) Cam impingement of the hip: a risk factor for hip osteoarthritis. Nat Rev Rheumatol 9(10):630–634CrossRef
10.
11.
Lee S, Nardo L, Kumar D et al (2015) Scoring hip osteoarthritis with MRI (SHOMRI): a whole joint osteoarthritis evaluation system. J Magn Reson Imaging 41(6):1549–1557CrossRef
12.
Hipfl C, Titz M, Chiari C et al (2017) Detecting cam-type deformities on plain radiographs: what is the optimal lateral view? Arch Orthop Trauma Surg 137(12):1699–1705CrossRef
13.
Nötzli HP, Wyss TF, Stoecklin CH et al (2002) The contour of the femoral head-neck junction as a predictor for the risk of anterior impingement. J Bone Joint Surg Br 84(4):556–560CrossRef
14.
Busse J, Gasteiger W, Tönnis D (1972) Eine neue Methode zur röntgenologischen Beurteilung eines Hüftgelenkes — Der Hüftwert. Archiv für orthopädische und Unfall-Chirurgie, mit besonderer Berücksichtigung der Frakturenlehre und der orthopädisch-chirurgischen Technik 72(1):1–9CrossRef
15.
Amenabar T, Piriz J, Mella C et al (2015) Reliability of 3 different arthroscopic classifications for chondral damage of the acetabulum. Arthroscopy 31(8):1492–1496CrossRef
16.
Ilizaliturri VM, Byrd JWT, Sampson TG et al (2008) A geographic zone method to describe intra-articular pathology in hip arthroscopy: cadaveric study and preliminary report. Arthroscopy 24(5):534–539CrossRef
17.
Petersilge CA (2000) From the RSNA Refresher Courses. Radiological Society of North America. Chronic adult hip pain: MR arthrography of the hip. Radiographics 20:43–52
18.
Portney LG, Watkins MP (2009) Foundations of Clinical Research: Applications to Practice, 3rd edn. Prentice Hall, Upper Saddle River
19.
Peterfy CG, Guermazi A, Zaim S et al (2004) Whole-Organ Magnetic Resonance Imaging Score (WORMS) of the knee in osteoarthritis. Osteoarthritis Cartilage 12:177–190CrossRef
20.
Linda DD, Naraghi A, Murnaghan L et al (2017) Accuracy of non-arthrographic 3T MR imaging in evaluation of intra-articular pathology of the hip in femoroacetabular impingement. Skeletal Radiol 46(3):299–308CrossRef
21.
Woertler K, Waldt S (2006) MR imaging in sports-related glenohumeral instability. Eur Radiol 16(12):2622–2636CrossRef
22.
Hobby JL, Dixon AK, Bearcroft PW et al (2001) MR imaging of the wrist: effect on clinical diagnosis and patient care. Radiology 220(3):589–593CrossRef
23.
Van Dyck P, Gielen JL, Vanhoenacker FM et al (2012) Diagnostic performance of 3D SPACE for comprehensive knee joint assessment at 3 T. Insights Imaging 3(6):603–610CrossRef
24.
Neumann G, Mendicuti AD, Zou KH et al (2007) Prevalence of labral tears and cartilage loss in patients with mechanical symptoms of the hip: evaluation using MR arthrography. Osteoarthritis Cartilage 15(8):909–917CrossRef
25.
Roemer FW, Hunter DJ, Winterstein A et al (2011) Hip Osteoarthritis MRI Scoring System (HOAMS): reliability and associations with radiographic and clinical findings. Osteoarthritis Cartilage 19(8):946–962CrossRef
26.
Schmid MR, Nötzli HP, Zanetti M et al (2003) Cartilage lesions in the hip: diagnostic effectiveness of MR arthrography. Radiology 226(2):382–386CrossRef
27.
Hunter DJ, Guermazi A, Lo GH et al (2011) Evolution of semiquantitative whole joint assessment of knee OA: MOAKS (MRI Osteoarthritis Knee Score). Osteoarthritis Cartilage 19(8):990–1002CrossRef
28.
Hunter DJ, Lo GH, Gale D et al (2008) The reliability of a new scoring system for knee osteoarthritis MRI and the validity of bone marrow lesion assessment: BLOKS (Boston Leeds Osteoarthritis Knee Score). Ann Rheum Dis 67(2):206–211CrossRef
29.
Schmaranzer F, Klauser A, Kogler M et al (2015) Diagnostic performance of direct traction MR arthrography of the hip: detection of chondral and labral lesions with arthroscopic comparison. Eur Radiol 25(6):1721–1730CrossRef
30.
Sutter R, Zubler V, Hoffmann A et al (2014) Hip MRI: how useful is intraarticular contrast material for evaluating surgically proven lesions of the labrum and articular cartilage? AJR Am J Roentgenol 202(1):160–169CrossRef
31.
Smith TO, Hilton G, Toms AP et al (2011) The diagnostic accuracy of acetabular labral tears using magnetic resonance imaging and magnetic resonance arthrography: a meta-analysis. Eur Radiol 21(4):863–874CrossRef
32.
Steinbach LS, Palmer WE, Schweitzer ME (2002) Special focus session. MR arthrography. Radiographics 22(5):1223–1246CrossRef
33.
Naraghi A, White LM (2015) MRI of labral and chondral lesions of the hip. AJR Am J Roentgenol 205(3):479–490CrossRef
34.
Chopra A, Grainger AJ, Dube B et al (2018) Comparative reliability and diagnostic performance of conventional 3T magnetic resonance imaging and 1.5T magnetic resonance arthrography for the evaluation of internal derangement of the hip. Eur Radiol 28(3):963–971CrossRef
35.
Lories RJ, Luyten FP (2011) The bone-cartilage unit in osteoarthritis. Nat Rev Rheumatol 7(1):43–49CrossRef
36.
Maas O, Joseph GB, Sommer G et al (2015) Association between cartilage degeneration and subchondral bone remodeling in patients with knee osteoarthritis comparing MRI and (99m)Tc-DPD-SPECT/CT. Osteoarthritis Cartilage 23(10):1713–1720CrossRef
37.
Tanamas SK, Wluka AE, Pelletier J-P et al (2010) The association between subchondral bone cysts and tibial cartilage volume and risk of joint replacement in people with knee osteoarthritis: a longitudinal study. Arthrit Res Ther 12(2):R58CrossRef
38.
Marra MD, Crema MD, Chung M et al (2008) MRI features of cystic lesions around the knee. Knee 15(6):423–438CrossRef
39.
Ganz R, Parvizi J, Beck M et al (2003) Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res (417): 112–120
40.
Lavigne M, Parvizi J, Beck M et al (2004) Anterior femoroacetabular impingement: part I. Techniques of joint preserving surgery. Clin Orthop Relat Res (418): 61–66.
41.
Dall’Oca C, Trivellin G, D’Orazio L et al (2016) Hip arthroscopy in osteoarthritis consequent to FAI. Acta Biomed 87(Suppl 1):46–52
Metadata
Title
Validation of scoring hip osteoarthritis with MRI (SHOMRI) scores using hip arthroscopy as a standard of reference
Authors
Jan Neumann
Alan L. Zhang
Benedikt J. Schwaiger
Michael A. Samaan
Richard Souza
Sarah C. Foreman
Gabby B. Joseph
Trevor Grace
Sharmila Majumdar
Thomas M. Link
Publication date
01-02-2019
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 2/2019
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-018-5623-8

Other articles of this Issue 2/2019

European Radiology 2/2019 Go to the issue

Hepatobiliary-Pancreas

The development and validation of magnetic resonance elastography for fibrosis staging in primary sclerosing cholangitis

Musculoskeletal

CAIPIRINHA-accelerated 10-min 3D TSE MRI of the ankle for the diagnosis of painful ankle conditions: Performance evaluation in 70 patients

Chest

Lung cancer screening with MRI: Evaluation of MRI for lung cancer screening by comparison of LDCT- and MRI-derived Lung-RADS categories in the first two screening rounds

Neuro

Imaging prediction of isocitrate dehydrogenase (IDH) mutation in patients with glioma: a systemic review and meta-analysis

Musculoskeletal

Compliance assessment and flip-angle measurement of the median nerve: sonographic tools for carpal tunnel syndrome assessment?

Vascular-Interventional

Mechanisms of recurrent haemoptysis after super-selective bronchial artery coil embolisation: a single-centre retrospective observational study