Hip Inflammation MRI Scoring System (HIMRISS) to predict response to hyaluronic acid injection in hip osteoarthritis

• Published in: Joint, bone, spine : revue du rhumatisme bone, spine : revue du rhumatisme, 2018-07, Vol.85 (4), p.475-480
• Main Authors: Deseyne, Nicolas, Conrozier, Thierry, Lellouche, Henri, Maillet, Bernard, Weber, Ulrich, Jaremko, Jacob L., Paschke, Joel, Epstein, Jonathan, Maksymowych, Walter P., Loeuille, Damien
• Format: Article
• Language: English
• Subjects: Aged; Bone marrow lesion; Chi-Square Distribution; Cohort Studies; Dose-Response Relationship, Drug; Drug Administration Schedule; Female; HIMRISS; Hip; Humans; Hyaluronate acid; Hyaluronic Acid - administration & dosage; Injections, Intra-Articular; Life Sciences; Magnetic resonance imaging (MRI); Magnetic Resonance Imaging - methods; Male; Middle Aged; Observer Variation; Osteoarthritis; Osteoarthritis, Hip - diagnostic imaging; Osteoarthritis, Hip - drug therapy; Pain Measurement; Prognosis; Prospective Studies; Range of Motion, Articular - drug effects; Severity of Illness Index; Statistics, Nonparametric; Synovitis; Synovitis - diagnostic imaging; Synovitis - drug therapy; Treatment Outcome
• ISSN: 1297-319X; 1778-7254
• DOI: 10.1016/j.jbspin.2017.08.004

To assess predictors of response, according to hip MRI inflammatory scoring system (HIMRISS), in a sample of patients with hip osteoarthritis (OA) treated by hyaluronic acid (HA) injection. Sixty patients with hip OA were included. Clinical outcomes were assessed at baseline and three months after HA injection by WOMAC. On hip MRI performed before HA injection, bone marrow lesion (BML) and synovitis were assessed by HIMRISS by four readers. The inter-reader reliability of HIMRISS was for HIMRISS total, acetabular BML, femoral BML and synovitis-effusion respectively 0.86, 0.64, 0.83 and 0.78. Associations between MRI features and clinical data were assessed. Logistic regression (univariate and multivariate) was used to explore associations between MRI features and response to HA injection, according to WOMAC50 response at three months. In total, 45.5% of patients met WOMAC50 response. Five adverse events were reported. At baseline, WOMAC function correlated significantly to HIMRISS synovitis-effusion (r=0.27, P=0.03). In univariate analysis, BML femoral according to binary assessment (P=0.025), HIMRISS BML femoral (P=0.0038), HIMRISS BML acetabular (P=0.042), HIMRISS total (P=0.0092) were associated negatively with WOMAC50 response. In multivariate analysis, adjusted for age and BMI, HIMRISS femoral BML (P=0.02) and HIMRISS total (P=0.016) were negatively associated with response. At a HIMRISS threshold of