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

Nicolas Deseyne, Thierry Conrozier, Henri Lellouche, Bernard Maillet, Ulrich Weber, Jacob L Jaremko, Joel Paschke, Jonathan Epstein, Walter P Maksymowych, Damien Loeuille

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

OBJECTIVE: 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.

METHOD: 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.

RESULTS: 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<15, 82% of patients were responders, with specificity SP=0.97, sensitivity SN=0.39, and positive and negative predictive values of 0.91 and 0.64, respectively.

CONCLUSION: HIMRISS is reliable for total scores and sub-domains. It permits identification of responders to HA injection in hip OA patients.

Original languageEnglish
JournalJoint Bone Spine
Volume85
Issue number4
Pages (from-to)475-480
ISSN1297-319X
DOIs
Publication statusPublished - 1. Jul 2018

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Hip Osteoarthritis
Hyaluronic Acid
Hip

Keywords

  • Bone marrow lesion
  • HIMRISS
  • Hip
  • Hyaluronate acid
  • Magnetic resonance imaging (MRI)
  • Osteoarthritis
  • Synovitis

Cite this

Deseyne, Nicolas ; Conrozier, Thierry ; Lellouche, Henri ; Maillet, Bernard ; Weber, Ulrich ; Jaremko, Jacob L ; Paschke, Joel ; Epstein, Jonathan ; Maksymowych, Walter P ; Loeuille, Damien. / Hip Inflammation MRI Scoring System (HIMRISS) to predict response to hyaluronic acid injection in hip osteoarthritis. In: Joint Bone Spine. 2018 ; Vol. 85, No. 4. pp. 475-480.
@article{c59f347a3f0f4d35a3bcc11f4d068407,
title = "Hip Inflammation MRI Scoring System (HIMRISS) to predict response to hyaluronic acid injection in hip osteoarthritis",
abstract = "OBJECTIVE: 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.METHOD: 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.RESULTS: 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<15, 82{\%} of patients were responders, with specificity SP=0.97, sensitivity SN=0.39, and positive and negative predictive values of 0.91 and 0.64, respectively.CONCLUSION: HIMRISS is reliable for total scores and sub-domains. It permits identification of responders to HA injection in hip OA patients.",
keywords = "Bone marrow lesion, HIMRISS, Hip, Hyaluronate acid, Magnetic resonance imaging (MRI), Osteoarthritis, Synovitis",
author = "Nicolas Deseyne and Thierry Conrozier and Henri Lellouche and Bernard Maillet and Ulrich Weber and Jaremko, {Jacob L} and Joel Paschke and Jonathan Epstein and Maksymowych, {Walter P} and Damien Loeuille",
note = "Copyright {\circledC} 2017. Published by Elsevier SAS.",
year = "2018",
month = "7",
day = "1",
doi = "10.1016/j.jbspin.2017.08.004",
language = "English",
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Deseyne, N, Conrozier, T, Lellouche, H, Maillet, B, Weber, U, Jaremko, JL, Paschke, J, Epstein, J, Maksymowych, WP & Loeuille, D 2018, 'Hip Inflammation MRI Scoring System (HIMRISS) to predict response to hyaluronic acid injection in hip osteoarthritis', Joint Bone Spine, vol. 85, no. 4, pp. 475-480. https://doi.org/10.1016/j.jbspin.2017.08.004

Hip Inflammation MRI Scoring System (HIMRISS) to predict response to hyaluronic acid injection in hip osteoarthritis. / Deseyne, Nicolas; Conrozier, Thierry; Lellouche, Henri; Maillet, Bernard; Weber, Ulrich; Jaremko, Jacob L; Paschke, Joel; Epstein, Jonathan; Maksymowych, Walter P; Loeuille, Damien.

In: Joint Bone Spine, Vol. 85, No. 4, 01.07.2018, p. 475-480.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Hip Inflammation MRI Scoring System (HIMRISS) to predict response to hyaluronic acid injection in hip osteoarthritis

AU - Deseyne, Nicolas

AU - Conrozier, Thierry

AU - Lellouche, Henri

AU - Maillet, Bernard

AU - Weber, Ulrich

AU - Jaremko, Jacob L

AU - Paschke, Joel

AU - Epstein, Jonathan

AU - Maksymowych, Walter P

AU - Loeuille, Damien

N1 - Copyright © 2017. Published by Elsevier SAS.

PY - 2018/7/1

Y1 - 2018/7/1

N2 - OBJECTIVE: 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.METHOD: 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.RESULTS: 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<15, 82% of patients were responders, with specificity SP=0.97, sensitivity SN=0.39, and positive and negative predictive values of 0.91 and 0.64, respectively.CONCLUSION: HIMRISS is reliable for total scores and sub-domains. It permits identification of responders to HA injection in hip OA patients.

AB - OBJECTIVE: 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.METHOD: 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.RESULTS: 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<15, 82% of patients were responders, with specificity SP=0.97, sensitivity SN=0.39, and positive and negative predictive values of 0.91 and 0.64, respectively.CONCLUSION: HIMRISS is reliable for total scores and sub-domains. It permits identification of responders to HA injection in hip OA patients.

KW - Bone marrow lesion

KW - HIMRISS

KW - Hip

KW - Hyaluronate acid

KW - Magnetic resonance imaging (MRI)

KW - Osteoarthritis

KW - Synovitis

U2 - 10.1016/j.jbspin.2017.08.004

DO - 10.1016/j.jbspin.2017.08.004

M3 - Journal article

C2 - 28893678

VL - 85

SP - 475

EP - 480

JO - Joint Bone Spine

JF - Joint Bone Spine

SN - 1297-319X

IS - 4

ER -