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. 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=-.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的强直性脊柱炎髋关节病综合评分系统：可行性研究与临床相关性


目的 开发基于 CT 的 AS 髋关节病评分系统。方法 前瞻性招募所有 AS 患者并征得同意，并接受全身立体放射摄影和骨盆 CT 检查，并由两名独立放射科医生进行评估。根据 Kellgreen-Lawrence 和 BASRI-h 评估立体放射线照片。对于 AS 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/糜烂进行评分。对患者的活动范围 (ROM)、疼痛和临床评分（BASMI、BASFI、ASQol、BASDAI 和 ASDAS）进行临床评估。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名患者，其中女性36/112，男性76/112。平均年龄为 51.0 ± 11.2 岁，平均 AS 持续时间为 20.9 ± 9.6 年。 HACTSAS、Kellgreen-Lawrence 和 BASRI-h 的 ICC 分别为 0.89、0.89 和 0.82。 HACTSAS 显示与 ROM (ρ=-0.41) 和 BASMI (ρ = 0.45) 具有中等绝对相关性，与疼痛 (ρ = 0.18) 和 BASFI (ρ = 0.25) 具有弱绝对相关性。 BASRI-h 和 Kellgreen-Lawrence 与 ROM 表现出中等相关性（分别为 ρ=-0.44 和 ρ=-0.40），与疼痛相关性弱（分别为 ρ=-.27 和 ρ=-0.23）和 BASFI（分别为 ρ=-0.16 和 ρ=-0.23）分别为 ρ=-0.18），但在 BASMI 中效果较弱（分别为 ρ=-0.34 和 ρ=-0.36）。内旋<15°、外展<31°和踝间距离<75cm对于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指标。