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J Rheumatol. 2014 Feb;41(2):359-69. doi: 10.3899/jrheum.131082. Epub 2013 Nov 15.

Methodologies for semiquantitative evaluation of hip osteoarthritis by magnetic resonance imaging: approaches based on the whole organ and focused on active lesions.

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From the Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada; Department of Radiology and Department of Rheumatology, Balgrist University Hospital, Zurich, Switzerland; Department of Medicine, CHU de NANCY-Brabois, Vandoeuvre, France; Department of Radiology, Klinikum Augsburg, Augsburg, Germany; Quantitative Imaging Center (QIC), Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA; Department of Medicine, University of British Columbia and Research Scientist, Arthritis Research Centre of Canada, Vancouver, British Columbia, Canada; St. Vincent's Hospital, Victoria, Australia; Radiology Department, Craigavon Area Hospital, Southern Health and Social Care Trust, Portadown, Northern Ireland; National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Chapel Allerton Hospital, Leeds, UK; Department of Rheumatology, Copenhagen University Hospital at Glostrup, Copenhagen, Denmark; Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.



As a wider variety of therapeutic options for osteoarthritis (OA) becomes available, there is an increasing need to objectively evaluate disease severity on magnetic resonance imaging (MRI). This is more technically challenging at the hip than at the knee, and as a result, few systematic scoring systems exist. The OMERACT (Outcome Measures in Rheumatology) filter of truth, discrimination, and feasibility can be used to validate image-based scoring systems. Our objective was (1) to review the imaging features relevant to the assessment of severity and progression of hip OA; and (2) to review currently used methods to grade these features in existing hip OA scoring systems.


A systematic literature review was conducted. MEDLINE keyword search was performed for features of arthropathy (such as hip + bone marrow edema or lesion, synovitis, cyst, effusion, cartilage, etc.) and scoring system (hip + OA + MRI + score or grade), with a secondary manual search for additional references in the retrieved publications.


Findings relevant to the severity of hip OA include imaging markers associated with inflammation (bone marrow lesion, synovitis, effusion), structural damage (cartilage loss, osteophytes, subchondral cysts, labral tears), and predisposing geometric factors (hip dysplasia, femoral-acetabular impingement). Two approaches to the semiquantitative assessment of hip OA are represented by Hip OA MRI Scoring System (HOAMS), a comprehensive whole organ assessment of nearly all findings, and the Hip Inflammation MRI Scoring System (HIMRISS), which selectively scores only active lesions (bone marrow lesion, synovitis/effusion). Validation is presently confined to limited assessment of reliability.


Two methods for semiquantitative assessment of hip OA on MRI have been described and validation according to the OMERACT Filter is limited to evaluation of reliability.



[Indexed for MEDLINE]

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