Hip-spine syndrome from the perspective of radiology: correlations between hip joint disease and lumbar spine MRI findings.

Abstract

Background: Hip joint (HJ) pain, which may be caused by lumbar disease, is a common complaint.

Purpose: To investigate the prevalence and specific correlations between various HJ diseases and lumbar spine magnetic resonance imaging (MRI) findings in patients with HJ pain.

Material and methods: Patients with the chief complaint of HJ pain who had both HJ MRI and lumbar MRI were retrospectively included. According to the existence of HJ disease, patients were divided into the following groups: non-HJ disease; osteoarthritis (OA); femoroacetabular impingement (FAI); ischiofemoral impingement (IFI); greater trochanter pain syndrome (GTPS); and other diseases. The prevalence of major lumbar MRI findings was compared. Correlations between HJ disease and major lumbar MR findings were explored.

Results: A total of 585 patients were included, of which 566 (96.8%) had major findings on lumbar MRI. The HJ disease group was more likely to be female and had more spondylolisthesis, while the non-HJ disease group had more low back or leg pain. The OA group was older and correlated with lumbar spinal stenosis (contingency coefficient = 0.164) and spondylolisthesis (contingency coefficient = 0.095). The FAI group was younger, had more male patients, and correlated with lumbosacral transitional vertebrae (contingency coefficient = 0.122). The IFI group was older, had more female patients, and correlated with facet joint osteoarthritis (contingency coefficient = 0.168). The GTPS group was older, had more female patients, and correlated with spondylolisthesis (contingency coefficient = 0.097).

Conclusion: Major lumbar MRI findings were frequently observed in patients with hip pain, even in patients without HJ disease. Specific lumbar MRI finding correlated with different HJ disease.