CT-based comprehensive scoring system for assessing hip arthropathy in ankylosing spondylitis: feasibility study with clinical correlation

Duarte Silva, F; Ormond Filho, AG; de Oliveira, TL; Andrew, D; Chhabra, A; Pinheiro, MM; Xi, Y; Fernandes, ADRC; Nico, MAC; Aihara, AY

doi:10.1093/rheumatology/keae415

CT-based comprehensive scoring system for assessing hip arthropathy in ankylosing spondylitis: feasibility study with clinical correlation

Rheumatology (Oxford)Published 7 Aug 2024Prospective feasibility study (development of a CT-based scoring system) with clinical correlation

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Authors' conclusion

HACTSAS exhibited higher correlation with BASMI and BASFI when compared with BASRI-h, but less correlation with pain and ROM. Internal rotation was the best clinical discriminator for hip arthropathy.

Study context

Population: AS patients undergoing whole-body stereoradiographs and pelvis CT; mean age 51.0 ± 11.2 years, mean AS duration 20.9 ± 9.6 years36 females · 76 males
Participants: 112 patients

Exposure: Hip arthropathy CT score in AS (HACTSAS) vs BASRI-h and Kellgreen-Lawrence
Outcome: Correlation of radiological scores with clinical parameters (ROM, pain, BASMI, BASFI, ASQol, BASDAI, ASDAS)

Methodological detailstwo independent radiologists

Two independent radiologists

Main finding

As reported in the abstract

Correlation (ρ) with clinical parameters

Group	ρ with range of motion (ROM)	ρ with BASMI	ρ with pain	ρ with BASFI
HACTSAS	−0.41	0.45	0.18	0.25
BASRI-h	−0.44	−0.34	−0.27	−0.16
Kellgreen-Lawrence	−0.40	−0.36	−0.23	−0.18

ρ with range of motion (ROM)

HACTSAS−0.41

BASRI-h−0.44

Kellgreen-Lawrence−0.40

ρ with BASMI

HACTSAS0.45

BASRI-h−0.34

Kellgreen-Lawrence−0.36

ρ with pain

HACTSAS0.18

BASRI-h−0.27

Kellgreen-Lawrence−0.23

ρ with BASFI

HACTSAS0.25

BASRI-h−0.16

Kellgreen-Lawrence−0.18

Observational data: associations, not effects.

Further findings

Intraclass correlation coefficients (ICC)

Outcome	HACTSAS	Kellgreen-Lawrence	BASRI-h
Inter-reader agreement (ICC)	0.89	0.89	0.82

ROM accuracy for hip arthropathy (BASRI-h ≥ 2)

Internal rotation <15°: sensitivity / specificity: 73% / 81%
Abduction <31°: sensitivity / specificity: 70% / 65%
Intermalleolar distance <75cm: sensitivity / specificity: 73% / 68%

Original publication

CT-based comprehensive scoring system for assessing hip arthropathy in ankylosing spondylitis: feasibility study with clinical correlation. Rheumatology (Oxford). Published 7 August 2024. doi:10.1093/rheumatology/keae415

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