Abstract：
OBJECTIVE: To develop a CT-based scoring system for assessment of hip arthropathy in AS.
METHODS: All AS patients were prospectively recruited, consented, and underwent whole-body stereoradiographs and pelvis CT, which were assessed by two independent radiologists. Stereoradiographs were assessed according to Kellgreen-Lawrence and BASRI-h. For the Hip arthropathy CT score in AS (HACTSAS), joints were divided into 7 segments and scored for joint space, osteophytes, subchondral cysts/erosions. Patients were clinically assessed for range of motion (ROM), pain, and clinical scores (BASMI, BASFI, ASQol, BASDAI and ASDAS). Radiological scores correlations with clinical parameters were compared. ROM sensitivity and specificity for hip arthropathy (BASRI-h ≥ 2) were calculated.
RESULTS: Sample included 112 patients, with 36/112 females and 76/112 males. Average age was 51.0 ± 11.2 years and mean duration of AS was 20.9 ± 9.6 years. ICC for HACTSAS, Kellgreen-Lawrence and BASRI-h were 0.89, 0.89 and 0.82 respectively. HACTSAS showed moderate absolute correlation with ROM (ρ=-0.41) and BASMI (ρ = 0.45), and weak with pain (ρ = 0.18) and BASFI (ρ = 0.25). BASRI-h and Kellgreen-Lawrence exhibited moderate correlation with ROM (ρ=-0.44 and ρ=-0.40, respectively), weak with pain (ρ=-.27and ρ=-0.23, respectively) and BASFI (ρ=-0.16 and ρ=-0.18, respectively), but only weak with BASMI (ρ=-0.34 and ρ=-0.36, respectively). Internal rotation <15°, abduction <31°, and intermalleolar distance <75cm were, respectively, 73%, 70% and 73% sensitivity and 81%, 65% and 68% specific for hip arthropathy.
CONCLUSIONS: HACTSAS exhibited higher correlation with BASMI and BASFI when compared with BASRI-h, but less correlation with pain and ROM. Internal rotation was the best clinical discriminator for hip arthropathy.
METHODS: All AS patients were prospectively recruited, consented, and underwent whole-body stereoradiographs and pelvis CT, which were assessed by two independent radiologists. Stereoradiographs were assessed according to Kellgreen-Lawrence and BASRI-h. For the Hip arthropathy CT score in AS (HACTSAS), joints were divided into 7 segments and scored for joint space, osteophytes, subchondral cysts/erosions. Patients were clinically assessed for range of motion (ROM), pain, and clinical scores (BASMI, BASFI, ASQol, BASDAI and ASDAS). Radiological scores correlations with clinical parameters were compared. ROM sensitivity and specificity for hip arthropathy (BASRI-h ≥ 2) were calculated.
RESULTS: Sample included 112 patients, with 36/112 females and 76/112 males. Average age was 51.0 ± 11.2 years and mean duration of AS was 20.9 ± 9.6 years. ICC for HACTSAS, Kellgreen-Lawrence and BASRI-h were 0.89, 0.89 and 0.82 respectively. HACTSAS showed moderate absolute correlation with ROM (ρ=-0.41) and BASMI (ρ = 0.45), and weak with pain (ρ = 0.18) and BASFI (ρ = 0.25). BASRI-h and Kellgreen-Lawrence exhibited moderate correlation with ROM (ρ=-0.44 and ρ=-0.40, respectively), weak with pain (ρ=-.27and ρ=-0.23, respectively) and BASFI (ρ=-0.16 and ρ=-0.18, respectively), but only weak with BASMI (ρ=-0.34 and ρ=-0.36, respectively). Internal rotation <15°, abduction <31°, and intermalleolar distance <75cm were, respectively, 73%, 70% and 73% sensitivity and 81%, 65% and 68% specific for hip arthropathy.
CONCLUSIONS: HACTSAS exhibited higher correlation with BASMI and BASFI when compared with BASRI-h, but less correlation with pain and ROM. Internal rotation was the best clinical discriminator for hip arthropathy.
摘要：
目的：开发一种基于CT的评估AS髋关节病变的评分系统。
方法：前瞻性招募所有AS患者，同意,做了全身立体放疗和骨盆CT,由两名独立的放射科医生评估。根据Kellgreen-Lawrence和BASRI-h评估立体放射照片。对于AS（HACTSAS）的髋关节病CT评分，关节分为7段，并对关节空间进行评分，骨赘,软骨下囊肿/糜烂。临床评估患者的活动范围（ROM），疼痛,和临床评分(BASMI，BASFI,ASQol,BASDAI和ASDAS)。比较放射学评分与临床参数的相关性。计算髋关节病变的ROM敏感性和特异性（BASRI-h≥2）。
结果：样本包括112名患者，36/112女性和76/112男性。平均年龄为51.0±11.2岁，平均AS病程为20.9±9.6岁。ICCforHACTSAS,Kellgreen-Lawrence和BASRI-h分别为0.89、0.89和0.82。HACTSAS与ROM（ρ=-0.41）和BASMI（ρ=0.45）显示出中等的绝对相关性，并伴有疼痛(ρ=0.18)和BASFI(ρ=0.25)。BASRI-h和Kellgreen-Lawrence与ROM表现出中等相关性（分别为ρ=-0.44和ρ=-0.40），弱疼痛（分别为ρ=-0.27和ρ=-0.23）和BASFI（分别为ρ=-0.16和ρ=-0.18），但只有BASMI弱(分别为ρ=-0.34和ρ=-0.36)。内旋<15°,外展<31°,和踝间距离<75cm，分别,73%,70%和73%的灵敏度和81%，65%和68%特异性为髋关节病。
结论：与BASRI-h相比，HACTSAS与BASMI和BASFI的相关性更高，但与疼痛和ROM的相关性较小。内旋是髋关节病的最佳临床鉴别器。
方法：前瞻性招募所有AS患者，同意,做了全身立体放疗和骨盆CT,由两名独立的放射科医生评估。根据Kellgreen-Lawrence和BASRI-h评估立体放射照片。对于AS（HACTSAS）的髋关节病CT评分，关节分为7段，并对关节空间进行评分，骨赘,软骨下囊肿/糜烂。临床评估患者的活动范围（ROM），疼痛,和临床评分(BASMI，BASFI,ASQol,BASDAI和ASDAS)。比较放射学评分与临床参数的相关性。计算髋关节病变的ROM敏感性和特异性（BASRI-h≥2）。
结果：样本包括112名患者，36/112女性和76/112男性。平均年龄为51.0±11.2岁，平均AS病程为20.9±9.6岁。ICCforHACTSAS,Kellgreen-Lawrence和BASRI-h分别为0.89、0.89和0.82。HACTSAS与ROM（ρ=-0.41）和BASMI（ρ=0.45）显示出中等的绝对相关性，并伴有疼痛(ρ=0.18)和BASFI(ρ=0.25)。BASRI-h和Kellgreen-Lawrence与ROM表现出中等相关性（分别为ρ=-0.44和ρ=-0.40），弱疼痛（分别为ρ=-0.27和ρ=-0.23）和BASFI（分别为ρ=-0.16和ρ=-0.18），但只有BASMI弱(分别为ρ=-0.34和ρ=-0.36)。内旋<15°,外展<31°,和踝间距离<75cm，分别,73%,70%和73%的灵敏度和81%，65%和68%特异性为髋关节病。
结论：与BASRI-h相比，HACTSAS与BASMI和BASFI的相关性更高，但与疼痛和ROM的相关性较小。内旋是髋关节病的最佳临床鉴别器。
