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Br J Radiol ; 93(1108): 20190817, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-31899657

RESUMEN

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 χ2. The t-test was used to compare pain change scores with MRI abnormalities. RESULTS: Patients with a normal labrum in the posterosuperior quadrant were more likely to report PGIC "improvement" at 1 week compared to labral degeneration (p = 0.048). Significant differences in pain change scores were found at all time points for the labral anteroinferior quadrant (p = 0.001, 1 day; p = 0.010, 1 week; 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 1 day (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 1 week. 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.


Asunto(s)
Articulación de la Cadera/diagnóstico por imagen , Imagen por Resonancia Magnética Intervencional , Osteoartritis de la Cadera/diagnóstico por imagen , Péptidos/administración & dosificación , Acetábulo/diagnóstico por imagen , Adulto , Anciano , Médula Ósea/diagnóstico por imagen , Cartílago/diagnóstico por imagen , Distribución de Chi-Cuadrado , Femenino , Articulación de la Cadera/efectos de los fármacos , Humanos , Inyecciones Intraarticulares/métodos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Osteoartritis de la Cadera/tratamiento farmacológico , Estudios Prospectivos , Estudios Retrospectivos , Factores de Tiempo , Resultado del Tratamiento
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