Hip MRI findings and outcomes following imaging-guided hip injections.

摘要

Objective: To determine if MRI findings prior to intra-articular corticosteroid hip infiltration are related to treatment outcomes. Methods: This prospective outcome study with retrospective MRI evaluation includes 100 consecutive patients with MRI within 6 months before a therapeutic intra-articular hip injection. Labrum, bone marrow, acetabular and femoral cartilage abnormalities were assessed by two radiologists blinded to patient outcomes: the proportion reporting "improvement" on the Patient's Global Impression of Change (PGIC) scale at 1 day, 1 week and 1 month follow-up were compared based on MRI findings using chi~2. The f-test was used to compare pain change scores with MRI abnormalities. Results: Patients with a normal labrum in the postero-superior quadrant were more likely to report PGIC "improvement" at 1week compared to labral degeneration (p = 0.048). Significant differences in pain change scores were found at all time points for the labral antero-inferior quadrant (p = 0.001, 1day; p = 0.010, 1week; p = 0.034, 1 month) with the highest reduction in patients with labral degeneration. Females were 2.80 times more likely to report clinically relevant "improvement" at 1day (p = .049) and 2.90 times more likely to report clinically relevant "improvement" at 1 month (p = .045). Conclusion: Cartilage defects and marrow abnormalities were not associated with outcomes. Patients with a normal labrum in the posterosuperior quadrant had better outcomes at 1week. Patients with labral degeneration of the anteroinferior quadrant had higher levels of pain reduction at all time points. Females were significantly more likely to report PGIC "improvement" Advances in knowledge: A significant treatment outcome was observed amongst gender, although there were no significant differences in the MRI findings.