Abstract:
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).
摘要:
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MRI检测到的膝关节结构异常和膝关节疼痛之间的关联。髋关节OA在许多方面与膝关节OA不同,但对髋关节结构异常在髋部疼痛中的作用知之甚少。这项研究旨在系统评估MRI上髋关节异常的相关性,如软骨缺损,骨髓病变(BMLs),骨赘,二尖瓣旁囊肿,渗出性滑膜炎,和软骨下囊肿,髋部疼痛。我们搜索了从开始到2024年2月的电子数据库,以确定报告了髋关节MRI特征与髋关节疼痛之间关联的数据的出版物。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CochraneBackReviewGroup方法指南评估了证据水平,并将其分为五个级别:强,中度,limited,冲突,也没有证据.共纳入9项研究,包括五项队列研究,三项横断面研究,和一项病例对照研究。中等水平的证据表明,BMLs的存在和变化与髋部疼痛的严重程度和进展呈正相关,其他MRI特征与髋部疼痛之间关联的证据有限,甚至存在冲突.只有少数样本量小到中等的研究评估了MRI上的髋关节结构变化与髋关节疼痛之间的关联。BMLs可能有助于髋部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。系统审查的协议已在PROSPERO注册(https://www。crd.约克。AC.英国/PROSPERO/,CRD42023401233)。