Validation of scoring hip osteoarthritis with MRI (SHOMRI) scores using hip arthroscopy as a standard of reference
To validate SHOMRI gradings in preoperative hip magnetic resonance imaging (MRI) with intra-arthroscopic evaluation of intraarticular hip abnormalities.
Preoperative non-arthrographic 3.0-T MRIs of 40 hips in 39 patients (1 patient with bilateral hip surgery) with femoroacetabular impingement (FAI) syndrome (mean age, 34.7 years ± 9.0; n = 16 females), refractory to conservative measures, that underwent hip arthroscopy were retrospectively assessed by two radiologists for chondrolabral abnormalities and compared with intra-arthroscopic findings as the standard of reference. Arthroscopically accessible regions were compared with the corresponding SHOMRI subregions and assessed for the presence and grade of cartilaginous pathologies in the acetabulum and femoral head. The acetabular labrum was assessed for the presence or absence of labral tears. For the statistical analysis sensitivity and specificity as well as intraclass correlation (ICC) for interobserver agreement were calculated.
Regarding chondral abnormalities, 58.8% of the surgical cases showed chondral defects. SHOMRI scoring showed a sensitivity of 95.7% and specificity of 84.8% in detecting cartilage lesions. Moreover, all cases with full-thickness defects (n = 9) were identified correctly, and in n = 6 cases (out of n = 36 with partial-thickness defects) the defective cartilage was identified but the actual depth overestimated. Labral tears were present in all cases and the MR readers identified 92.5% correctly. ICC showed a good interobserver agreement with 86.3% (95% CI 80.0, 90.6%)
Using arthroscopic correlation, SHOMRI grading of the hip proves to be a reliable and precise method to assess chondrolabral hip joint abnormalities.
• Assessment of hip abnormalities using MRI with surgical correlation.
• Comparing surgery and MRI by creating a hybrid anatomic map that covers both modalities.
• Non-arthrographic use of 3.0-T MRI provides detailed information on cartilage and labral abnormalities in hip joints.
KeywordsMagnetic resonance imaging Evaluation studies Hip joint Arthroscopy Chondrolabral injuries
Magnetic resonance imaging
Negative predictive value
Positive predictive value
Scoring hip osteoarthritis with MRI
This study has received funding by the NIH/NIAMS (National Institute of Arthritis and Musculoskeletal and Skin Diseases) grants P50 AR060752, R01 AR069006 and F32 AR069458.
Compliance with ethical standards
The scientific guarantor of this publication is Prof. Thomas M. Link, MD, PhD, Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA.
Conflict of interest
The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.
Statistics and biometry
One of the authors has significant statistical expertise.
Written informed consent was obtained from all subjects (patients) in this study.
Institutional Review Board approval was obtained.
• diagnostic study
• performed at one institution
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