Anatomic Features Associated With Femoroacetabular Impingement Are Equally Common in Hips of Old and Young Asymptomatic Individuals Without CT Signs of Osteoarthritis
Anatomic Features Associated With Femoroacetabular Impingement Are Equally Common in Hips of Old and Young Asymptomatic Individuals Without CT Signs of Osteoarthritis
复制标题
DOI：
10.2214/ajr.12.10083
复制
发表时间：
2014-05-01
影响因子：
5
通讯作者：
Vande Berg, Bruno C.
中科院分区：
文献类型：
--
作者：
Omoumi, Patrick;Thiery, Cecile;Vande Berg, Bruno C.
OBJECTIVE.本文的目的是评估和比较两个年龄组之间无骨关节炎CT征象的无症状髋关节股骨髋臼撞击（FAI）CT征象的患病率和测量值：40岁以下和60岁以上。我们前瞻性地纳入了因非骨科适应症接受胸腹盆MDCT的患者，这些患者的髋关节无症状，排除了CT显示有骨关节炎体征的髋关节。入组了两个年龄组，每个年龄组包括75个髋关节（< 40岁：平均年龄31岁; 15名女性; > 60岁：平均年龄66岁; 21名女性）。两名观察员独立进行图像分析。使用差异和等效性检验比较凸轮（α角和股骨头-颈偏心距）和钳形（髋臼扭转角、髋臼指数、外侧中心-边缘角、交叉征和后壁征）FAI形态类型的发生率和定量值。评估观察者内一致性。FAI的CT征象的患病率很高，并且在两组中根据征象和截止值显示出很大的变化（cam为9-63%; pinch为3-50%）。两个年龄组凸轮形态型的CT征象的患病率和测量值相当。除了髋臼扭转角、外侧中心边缘角和交叉征没有发现统计学差异外，各年龄组之间钳形形态CT征的患病率和测量值在统计学上相等，但未达到统计学等效性。观察者间和观察者内一致性为中等至几乎完美（kappa = 0.72-0.89;组内相关系数，0.42-0.94）。在两个年龄组的无症状非骨关节炎髋关节患者中，大多数FAI形态类型的CT征象的患病率和测量值都很高，并且相当。
OBJECTIVE. The purpose of this article is to evaluate and compare the prevalence and measurement values of CT signs of femoroacetabular impingement (FAI) in asymptomatic hips without CT signs of osteoarthritis between two age groups: younger than 40 years and older than 60 years.SUBJECTS AND METHODS. We prospectively included patients undergoing thoracoabdominopelvic MDCT for nonorthopedic indications with asymptomatic hips and excluded hips with signs of osteoarthritis seen on CT. Two age groups including 75 hips each were enrolled (< 40 years old: mean age, 31 years; 15 women; > 60 years old: mean age, 66 years; 21 women). Two observers independently performed the image analysis. Prevalences and quantitative values of the cam (alpha angle and femoral head-neck offset) and pincer (acetabular version angle, acetabular index, lateral center-edge angle, crossover sign, and posterior wall sign) FAI morphotypes were compared using both difference and equivalence tests. Intraobserver agreement was assessed.RESULTS. The prevalence of CT signs of FAI were high and showed great variation depending on the signs and cutoff values, in both groups (9-63% for cam; 3-50% for pincer). The prevalence and measurement values of CT signs of the cam morphotype were equivalent between the two age groups. The prevalence and measurement values of CT signs of the pincer morphotype were statistically equivalent between the age groups except for the acetabular version angle, lateral center-edge angle, and crossover sign for which no statistical difference was found, but statistical equivalence was not reached. Interobserver and intraobserver agreement were moderate to almost perfect (kappa = 0.72-0.89; intraclass correlation coefficient, 0.42-0.94).CONCLUSION. The prevalence and measurement values of most CT signs of FAI morphotypes were high and equivalent between the two age groups of patients with asymptomatic nonosteoarthritic hips.