Neumann, et al5 | HOAMS6 | HIMRISS8 | |
---|---|---|---|
Concept | Overall grading of hip degeneration, as statistical combination of maximum changes in each of 5 zones | Score of 14 features of osteoarthritis in the hip, developed by multidisciplinary consensus committee | Sum of signs of inflammation (edema, synovitis, effusion) in portions of femoral head, acetabulum and adjacent tissue, across each slice of MRI |
Base sequence | MR arthrogram | Proton density fat saturated (PD FS), small field of view (1 hip), axial and sagittal | Coronal inversion recovery (STIR), can be large field of view (full pelvis) or 1 hip |
Zones: femoral head | 1 | 5 sectors in central hip: central-central, central-superior, central-inferior, central-medial, central-lateral | Central 5 slices: 8 equal sectors of arc + 1 central zone, per slice |
4 zones in anterior and posterior 9 mm of femoral head: anterosuperior, anteroinferior, posterosuperior, posteroinferior | 2 zones (superior and inferior) per slice up to 5 anterior slices and up to 5 posterior slices | ||
Zones: acetabulum | 4 | 3 sectors in central hip (central-central, central-superior, central-inferior); 2 sectors in anterior and posterior 9 mm (superior and inferior) | 3 sectors per slice for central 5 slices; 2 sectors per slice for up to 5 anterior slices, 5 posterior |
Zones: total | 5 total | 9 femoral, 5 acetabular, total 14 | 65 femoral, 35 acetabular, total 100 |
Planes to use | Coronal for central slices, sagittal for ant/post | Coronal only | |
Cartilage | 0 normal | 0 normal | Not scored |
1 = signal change only | 1 focal partial thickness < 25% of region area | ||
2 fissuring only, < 1 mm width | 2 focal full thickness < 25% of region area | ||
3 defect < 50% of thickness | 3 several partial or 1 full > 25% | ||
4 defect > 50% of thickness | 4 several full thickness defects or one large, > 25% | ||
5 exposed bone | |||
Width of lesion | |||
A = < 1 cm, B = 1–2 cm, C = > 2 cm per zone | |||
BML | 0 = none | 0 = none | 0 = normal |
1 = < 0.5 cm from bone | 1 = < 33% of region | 1 = higher signal than reference signal (uninvolved or contralateral marrow) | |
2 = < 1.5 cm from bone | 2 = < 66% of region | ||
3 = > 1.5 cm from bone | 3 = > 66% of region | ||
Subchondral cysts | Grade whole joint: 0 none | 0 = none | Not scored |
1 = 1–2 cysts | 1 = < 33% of region | ||
2 = 3–4 cysts | 2 = < 66% of region | ||
3 = 5+ cysts | 3 = > 66% of region | ||
Osteophytes | |||
Locations | 5 zones (ant/post/med/lat + central) | Femoral in each location | Not scored |
Scoring | Per zone: 0 = absent; 1 = mild (< 2 mm); 2 = mod (< 5 mm); 3 = severe > 5 mm | 5 locations: (ant/post on axial slices; superomedial/inferolateral/central intra-articular on coronal slices) | |
Whole-joint score, from sum of partial scores: 0 if 0; 1 if 1–2; 2 if 3–4; 3 if > 5+ | 0 absent; 1 = equivocal; 2 = small definite beak-like; 3 = intermediate; 4 = large proliferative | ||
Labrum | |||
Locations | Anterior/posterior/medial/lateral | Anterior on sagittal; superolateral/posteromedial on coronal; anterior/posterior on axial | Not scored |
Scoring | 0 = normal | 0 = normal | |
1 = signal change or small labrum | 1 = signal change or small labrum | ||
2 = simple tear | 2 = simple tear | ||
3 = complex tear | 3 = maceration | ||
Synovitis | |||
Locations | 4 sites: ant/post/med/lat femoral head/neck junction | Scored once per slice × 15 slices | |
Scoring | NA | Synovium only; thickness 0 if < 2 mm; 1 if 2–4 mm; 2 if > 4 mm | Combined synovium + effusion: thickness 0 < 2 mm; 1 if 2–4 mm; 2 if > 4 mm |
Effusion | NA | Single grade 0, 1, 2 (overall joint assessment) | Combined with synovitis |
Other | |||
Loose bodies | NA | Present or absent | NA |
Attrition (flattened articular surface) | 1 if definite flattening/asphericity of femoral head | ||
Dysplasia (undercoverage of acetabular roof) | Measure centre-edge angle at mid coronal slice, if < 25*, score as dysplastic | ||
Bursitis/enthesopathy | Trochanteric bursitis, greater & lesser trochanteric tendinopathy each either present or absent | ||
Paralabral cysts | Present or absent | ||
Superolateral femoral head cyst | Present or absent (“herniation pit”) | ||
Maximum score | Statistical combination scheme using max. individual score at each site | 45 (cartilage) + 45 (BML) + 45 (cysts) + 40 (osteophytes) + 15 (labrum) + 8 (synovitis) + 10 (other) = 208 | 57 (femoral head BML) + 27 (acetabular BML) + 30 (synovitis/effusion) = 114 |
HOAMS: Hip OsteoArthritis Scoring System; HIMRISS: Hip Inflammation MRI Scoring System; BML: bone marrow lesion; NA: not applicable.