Objective To develop a CT-based scoring system for assessment of hip arthropathy in AS. Methods All AS patients were prospectively recruited, consented and underwent whole-body stereoradiographs and pelvis CT, which were assessed by two independent radiologists. Stereoradiographs were assessed according to Kellgreen-Lawrence and BASRI-h. For the Hip arthropathy CT score in AS (HACTSAS), joints were divided into 7 segments and scored for joint space, osteophytes, subchondral cysts/erosions. Patients were clinically assessed for range of motion (ROM), pain and clinical scores (BASMI, BASFI, ASQol, BASDAI and ASDAS). Radiological scores correlations with clinical parameters were compared. ROM sensitivity and specificity for hip arthropathy (BASRI-h ≥ 2) were calculated. Results Sample included 112 patients, with 36/112 females and 76/112 males. Average age was 51.0 ± 11.2 years and mean duration of AS was 20.9 ± 9.6 years. Intraclass correlation coefficients (ICC) for HACTSAS, Kellgreen-Lawrence and BASRI-h were 0.89, 0.89 and 0.82, respectively. HACTSAS showed moderate absolute correlation with ROM (ρ = −0.41) and BASMI (ρ = 0.45), and weak with pain (ρ = 0.18) and BASFI (ρ = 0.25). BASRI-h and Kellgreen-Lawrence exhibited moderate correlation with ROM (ρ = −0.44 and ρ = −0.40, respectively), weak with pain (ρ = −0.27and ρ = −0.23, respectively) and BASFI (ρ = −0.16 and ρ = −0.18, respectively), but only weak with BASMI (ρ = −0.34 and ρ = −0.36, respectively). Internal rotation <15°, abduction <31° and intermalleolar distance <75cm were, respectively, 73%, 70% and 73% sensitivity and 81%, 65% and 68% specific for hip arthropathy. Conclusion HACTSAS exhibited higher correlation with BASMI and BASFI when compared with BASRI-h, but less correlation with pain and ROM. Internal rotation was the best clinical discriminator for hip arthropathy.

中文翻译：

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基于 CT 的综合评分系统评估强直性脊柱炎髋关节病：具有临床相关性的可行性研究


目的 开发基于 CT 的评分系统，用于评估 AS 患者的髋关节病。方法 前瞻性招募所有 AS 患者，同意并接受全身立体放射线和盆腔 CT，由两名独立的放射科医生进行评估。根据 Kellgreen-Lawrence 和 BASRI-h 评估立体放射照片。对于 AS 中的髋关节病 CT 评分 （HACTSAS），将关节分为 7 个节段，并对关节间隙、骨赘、软骨下囊肿/侵蚀进行评分。临床评估患者的运动范围 （ROM） 、疼痛和临床评分 （BASMI 、 BASFI 、 ASQol 、 BASDAI 和 ASDAS）。比较放射学评分与临床参数的相关性。计算髋关节病的 ROM 敏感性和特异性 （BASRI-h ≥ 2）。结果 样本包括 112 例患者，其中女性 36/112 例，男性 76/112 例。平均年龄为 51.0 ± 11.2 岁，AS 的平均持续时间为 20.9 ± 9.6 岁。HACTSAS 、 Kellgreen-Lawrence 和 BASRI-h 的类内相关系数 （ICC） 分别为 0.89 、 0.89 和 0.82。HACTSAS 与 ROM （ρ = -0.41） 和 BASMI （ρ = 0.45） 呈中等绝对相关性，与疼痛 （ρ = 0.18） 和 BASFI （ρ = 0.25） 呈弱绝对相关性。BASRI-h 和 Kellgreen-Lawrence 与 ROM （分别为 ρ = -0.44 和 ρ = -0.40） 表现出中等相关性，疼痛较弱 （分别为 ρ = -0.27 和 ρ = -0.23） 和 BASFI （分别为 ρ = -0.16 和 ρ = -0.18），但与 BASMI 仅较弱 （分别为 ρ = -0.34 和 ρ = -0.36）。内旋 <15°、外展 <31° 和踝间距离 <75cm 对髋关节病的敏感性分别为 73% 、 70% 和 73%，特异性为 81% 、 65% 和 68%。结论 与 BASRI-h 相比，HACTSAS 与 BASMI 和 BASFI 的相关性较高，但与疼痛和 ROM 的相关性较低。 内旋是髋关节病的最佳临床鉴别因素。