Ligamentum Teres Lesions Are Associated with Compositional and Structural Hip Cartilage Degenerative Change: Region-specific Cartilage Degeneration

Overview

Journal Eur Radiol

Specialty Radiology

Date 2024 Aug 23

PMID 39177856

Authors

Zehra Akkaya

Paula J Giesler

Koren E Roach

Gabby B Joseph

Charles E McCulloch

Upasana U Bharadwaj

Richard B Souza

Sharmila Majumdar

Thomas M Link

Affiliations

Soon will be listed here.

Abstract

Objectives: To investigate the association between magnetic resonance imaging (MRI)-based ligamentum teres lesions (LTL) and structural hip degeneration.

Methods: Bilateral 3-T hip MRIs of participants (n = 93 [36 men]; mean age ( ± SD) 51 years ± 15.4) recruited from the community and the orthopedic clinic of a single medical center were included. Clinical and imaging data acquired included hip disability and osteoarthritis outcome scores, semi-quantitative scoring of hip osteoarthritis on MRI (SHOMRI) scores on fluid-sensitive sequences, and cartilage T/T compositional sequences. An MRI-based LTL scoring system, incorporating continuity, thickening, and signal intensity, ranging from 0 (normal) to 4 (complete tear) was constructed. Hip morphological features associated with LTL, based on functional or anatomical relationships to LT, were defined. Relationships between MRI-LT scores and SHOMRI, global/regional cartilage T/T, and proposed morphological abnormalities and LTL were explored by mixed effects linear and logistic regression models.

Results: In 82 (46.1%) hips, no pain was documented; 118 (63.4%) and 68 (36.6%) hips were graded as KL-grade ≤ 1 and ≥ 2, respectively. Compared to MRI-LT score = 0 (normal), score = 4 (complete tear) revealed significantly worse subchondral bony degenerative changes for bone marrow lesions (SHOMRI-BML) and subchondral cysts (SHOMRI-sc) (p < 0.001, p = 0.015, respectively). Global acetabular T, femoral T were significantly increased for abnormal MRI-LT scores (p-range = 0.005-0.032). Regional analyses revealed significantly increased T/T in central acetabular/increased T in off-central femoral regions (p-range = 0.005-0.046). Pulvinar effusion-synovitis, shallow fovea, and foveal osteophytes were significantly associated with abnormal LT MRI findings (p-range = < 0.001-0.044).

Conclusion: MRI abnormalities of LT are associated with worse SHOMRI-sc/BML scores, indicative of hip osteoarthritis and higher T and T that differ by region. Pulvinar effusion-synovitis and changes in femoral head morphology are associated with LTL.

Clinical Relevance Statement: Abnormal ligamentum teres findings identified via MRI are associated with structural degenerative changes of the hip joint and alterations in acetabular and femoral cartilage compositions show spatial differences in relation to LTL.

Key Points: The clinical significance of common ligamentum teres lesions (LTL) on MRI is not well understood. LTL identified by an MRI-based scoring system is associated with worse biomarkers, indicating more advanced degenerative hip changes. Effusion-synovitis signal at pulvinar, shallow fovea capitis, and foveal osteophytes are associated with LTL on imaging.

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