Is hip capsule morphology associated with hip pain in patients without another structural correlate?
Is hip capsule morphology associated with hip pain in patients without another structural correlate?
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DOI：
10.1007/s00330-023-10307-w
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发表时间：
2024-01-03
影响因子：
5.9
通讯作者：
Link，Thomas M.
中科院分区：
文献类型：
--
作者：
Luitjens，Johanna;Gassert，Felix G.;Link，Thomas M.
目的本研究的目的是(i)评估没有任何其他与疼痛相关的MRI异常的患者的髋关节囊形态与疼痛之间的关系，（ii）调查髋关节疼痛患者的髋关节囊形态是否与对照组不同。方法本研究纳入76例MRI未显示任何结构异常的髋关节疼痛成人和46例无症状志愿者。人工分割前、后髋关节囊。量化髋前囊总面积和平均面积、后囊面积、前后囊面积比和前囊内侧外侧面积比。使用逻辑回归模型评估疼痛组与对照组之间的差异。结果与对照组相比，髋部疼痛患者的前后面积比明显降低（p= 0.002）。疼痛组髋后囊面积明显大于对照组（p= 0.001）。此外，疼痛组前囊内侧和外侧的比值明显降低（p= 0.004）。结论与对照组相比，髋关节疼痛患者的后囊更厚，前后囊面积比更小；前内侧囊更薄，前内侧囊室比更小。临床相关性声明在对髋关节疼痛患者进行MRI评估时，应评估髋关节囊的形态。本研究旨在为未来的分析奠定基础，以确定区分正常和异常髋关节囊测量的阈值。•即使使用MRI等现代成像方式，处理髋关节疼痛患者的最大挑战之一是找到疼痛的结构联系。•与髋关节疼痛相关的髋关节囊形态显示髋关节后囊面积较大，前后囊面积比较低，以及内侧前囊面积较小，内侧与外侧前囊比较低。•在MRI未显示其他形态异常的患者中，髋关节囊形态与髋关节疼痛相关，在临床实践中应引起更多关注。
ObjectiveThe goals of this study were (i) to assess the association between hip capsule morphology and pain in patients without any other MRI abnormalities that would correlate with pain and (ii) to investigate whether hip capsule morphology in hip pain patients is different from that of controls.MethodsIn this study, 76 adults with hip pain who did not show any structural abnormalities on MRI and 46 asymptomatic volunteers were included. Manual segmentation of the anterior and posterior hip capsules was performed. Total and mean anterior hip capsule area, posterior capsule area, anterior-to-posterior capsule area ratio, and medial-to-lateral area ratio in the anterior capsule were quantified. Differences between the pain and control groups were evaluated using logistic regression models.ResultsPatients with hip pain showed a significantly lower anterior-to-posterior area ratio as compared with the control group (p= 0.002). The pain group’s posterior hip capsule area was significantly larger than that of controls (p= 0.001). Additionally, the ratio between the medial and lateral sections of the anterior capsule was significantly lower in the pain group (p= 0.004).ConclusionsPatients with hip pain are more likely to have thicker posterior capsules and a lower ratio of the anterior-to-posterior capsule area and thinner medial anterior capsules with a lower ratio of the medial-to-lateral anterior hip capsule compartment, compared with controls.Clinical relevance statementDuring MRI evaluations of patients with hip pain, morphology of the hip capsule should be assessed. This study aims to be a foundation for future analyses to identify thresholds distinguishing normal from abnormal hip capsule measurements.Key Points• Even with modern image modalities such as MRI, one of the biggest challenges in handling hip pain patients is finding a structural link for their pain.• Hip capsule morphologies that correlated with hip pain showed a larger posterior hip capsule area and a lower anterior-to-posterior capsule area ratio, as well as a smaller medial anterior capsule area with a lower medial-to-lateral anterior hip capsule ratio.• The hip capsule morphology is correlated with hip pain in patients who do not show other morphology abnormalities in MRI and should get more attention in clinical practice.