Longitudinal assessment of MRI in hip osteoarthritis using SHOMRI and correlation with clinical progression

Abstract

PURPOSE To assess the evolution of MR imaging findings in normal volunteers and subjects with hip osteoarthritis (OA) over 1.5 years described by the semi-quantitative Scoring Hip OA with MRI (SHOMRI) scoring system and their correlation with the evolution of clinical parameters. MATERIALS AND METHODS Hip MRI studies of 18 subjects with (Kellgren-Lawrence (KL) score 2/3; mean age 54.4±11.2 years; 27.8% women) and 36 controls without radiographic OA (KL 0/1; mean age 43.7±12.8 years; 50.0% women) were assessed at baseline and after 1.5 years by using SHOMRI, and their clinical status was evaluated by using Harris Hip Score and Hip Disability and Osteoarthritis Outcome Score (HOOS). Imaging and clinical parameters at baseline and their change over time were compared between groups using Mann Whitney U and Fisher’s exact tests. Spearman’s rank correlations and generalized linear models adjusted for age, sex, BMI and KL were used to assess associations between imaging and clinical findings. RESULTS At baseline, OA subjects had significantly higher SHOMRI total scores than controls (median (IQR), 12.5 (6–19.5) vs. 7 (4–13.5); p=0.024). Over 1.5 years, only the progression rate of subchondral cysts was significantly higher in OA subjects than in controls (16.7 vs. 0.0%; p=0.033), while no significant differences were found for any of the other SHOMRI subscales. Baseline bone marrow edema pattern (BMEP) was significantly associated with worsening pain (HOOS subscale; p=0.018) and hip-related quality of life (HOOS subscale; p=0.044). Progression of subchondral cysts was significantly associated with worsening symptoms other than pain (HOOS subscale, p=0.030). Baseline KL did not significantly correlate with worsening of any clinical symptoms (each, p>0.05). CONCLUSION In this relatively young study population without or with mild to moderate radiographic hip OA, only minimal differences were found between groups regarding the progression of hip abnormalities as assessed by SHOMRI over 1.5 years. However, BMEP predicted clinical worsening and subchondral cyst progression was associated with worsening symptoms. Although longer follow-up periods are required, this suggests that SHOMRI is a useful tool to monitor hip abnormalities and their progression longitudinally.

Using the Scoring Hip Osteoarthritis with Magnetic Resonance Imaging (SHOMRI) system to assess intra‐articular pathology in femoroacetabular impingement

“…Each radiologist had at least 5‐year of musculoskeletal experience and at least 2‐year of experience using SHOMRI, including a 4‐week initial consensus training meant to calibrate and standardize readings. Such consensus training has previously shown to produce excellent intra‐reader and inter‐reader correlation (Intra‐Class Correlation Coefficient >0.9) for SHOMRI readings in both arthritic and non‐arthritic patients …”

“…SHOMRI is a newly‐developed, MRI‐based tool designed to quantify the burden and progression of intra‐articular changes that occur with hip osteoarthritis . It has been shown to have excellent reproducibility and to correlate well with radiographic signs of hip arthritis as well as patient reported outcomes …”

Study of the interactions between proximal femur 3d bone shape, cartilage health, and biomechanics in patients with hip Osteoarthritis

“…The MRI protocol adopted for this study is descried in Table 1. Semi-quantitative clinical grading of acetabular and femoral cartilage abnormalities was performed using the Scoring Hip Osteoarthritis with MRI (SHOMRI) scoring system [33, 34]. …”

“…Semi-quantitative clinical grading of acetabular and femoral cartilage abnormalities was performed using the Scoring Hip Osteoarthritis with MRI (SHOMRI) scoring system. 33,34 Image Processing: 3D Shape Analysis All image processing was performed using an in-house program developed in Matlab (The Mathworks, Natick, MA). The proximal femurs of all the subjects were segmented automatically on the T1r-weighted image with TSL ¼ 0 using a single atlas-based method 13 refined by active contours.…”

Joint Loading in the Sagittal Plane During Gait Is Associated With Hip Joint Abnormalities in Patients With Femoroacetabular Impingement

“…The SHOMRI system 18 has been previously used in assessments of hip joint abnormalities in patients with hip OA. 8,16,28,29 Two musculoskeletal radiologists (B.J.S., T.M.L. ), with a combined 30 years of experience, performed the assessments of hip joint abnormalities with interclass and intraclass coefficients of >0.90.…”