THE AMERICAN-COLLEGE-OF-RHEUMATOLOGY CRITERIA FOR THE CLASSIFICATION AND REPORTING OF OSTEOARTHRITIS OF THE HIP
THE AMERICAN-COLLEGE-OF-RHEUMATOLOGY CRITERIA FOR THE CLASSIFICATION AND REPORTING OF OSTEOARTHRITIS OF THE HIP
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DOI：
10.1002/art.1780340502
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发表时间：
1991-05-01
影响因子：
--
通讯作者：
WOLFE, F
中科院分区：
文献类型：
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作者：
ALTMAN, R;ALARCON, G;WOLFE, F
通过一项多中心研究制定了骨关节炎（OA）相关髋关节疼痛患者的临床分类标准。 分析了201例在前一个月的大部分时间内发生髋关节疼痛的患者的数据。 对照组患者有其他原因的髋关节疼痛，如类风湿性关节炎或脊柱关节病。 来自病史、体格检查、实验室检查和X光片的变量被用来制定不同的标准，以服务于不同的研究目的。 多变量方法包括传统的“标准数”格式和“分类树”techniques.Clinical criteria：一个分类树的开发，没有射线照片，临床和实验室标准或临床标准。 如果疼痛与1）髋关节内旋大于或等于15度、髋关节内旋疼痛、髋关节晨僵小于或等于60分钟、年龄> 50岁，或2）髋内旋< 15度且红细胞沉降率（ESR）小于或等于45 mm/小时;如果未获得ESR，则以髋关节屈曲小于或等于115度代替（灵敏度86%;特异性75%）。临床加放射学标准：传统形式将疼痛与以下3个标准中的至少2个结合起来：骨赘（股骨或髋臼），关节间隙狭窄（上级，轴向和/或内侧），ESR < 20 mm/h（敏感性89%;特异性91%）。 骨赘的影像学表现通过分类树方法最好地区分了OA患者和对照组（敏感性89%;特异性91%）。“存在的标准数量”格式产生的标准以及敏感性和特异性水平与联合临床和影像学标准集的分类树相似。 对于临床标准集，分类树提供了更大的特异性。 强调了影像学检查骨赘在区分髋关节骨性关节炎患者和其他原因引起的髋关节疼痛患者中的价值。
Clinical criteria for the classification of patients with hip pain associated with osteoarthritis (OA) were developed through a multicenter study. Data from 201 patients who had experienced hip pain for most days of the prior month were analyzed. The comparison group of patients had other causes of hip pain, such as rheumatoid arthritis or spondylarthropathy. Variables from the medical history, physical examination, laboratory tests, and radiographs were used todevelop different sets of criteria to serve different investigative purposes. Multivariate methods included the traditional "number of criteria present" format and "classification tree" techniques.Clinical criteria: A classification tree was developed, without radiographs, for clinical and laboratory criteria or for clinical criteria alone. A patient was classified as having hip OA if pain was present in combination with either 1) hip internal rotation greater-than-or-equal-to 15-degrees, pain present on internal rotation of the hip, morning stiffness of the hip for less-than-or-equal-to 60 minutes, and age > 50 years, or 2) hip internal rotation < 15-degrees and an erythrocyte sedimentation rate (ESR) less-than-or-equal-to 45 mm/hour; if no ESR was obtained, hip flexion less-than-or-equal-to 115-degrees was substituted (sensitivity 86%; specificity 75%).Clinical plus radiographic criteria: The traditional format combined pain with at least 2 of the following 3 criteria: osteophytes (femoral or acetabular), joint space narrowing (superior, axial, and/or medial), and ESR < 20 mm/hour (sensitivity 89%; specificity 91%). The radiographic presence of osteophytes best separated OA patients and controls by the classification tree method (sensitivity 89%; specificity 91%).The "number of criteria present" format yielded criteria and levels of sensitivity and specificity similar to those of the classification tree for the combined clinical and radiographic criteria set. For the clinical criteria set, the classification tree provided much greater specificity. The value of the radiographic presence of an osteophyte in separating patients with OA of the hip from those with hip pain of other causes is emphasized.