ArticleSkeletal radiology2021
MARS MRI assessment of fatty degeneration of the gluteal muscles in patients with THA: reliability and accuracy of commonly used classification systems.
Article in Skeletal radiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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11 citing papers in PubMed, 15 citations in OpenAlex.
- Platelet-rich plasma does not influence magnetic resonance imaging findings of the gluteus muscles after total hip arthroplasty through the Hardinge approach.Skeletal radiology · 2025Trial
- A Novel MRI Classification System for Hip Abductor Muscle Atrophy: The Wisconsin Hip Abductor (WHAb) Classification System.Orthopaedic journal of sports medicine · 2026Article
- MRI assessment of muscle damage after posterolateral versus SuperPATH approach for total hip arthroplasty.Scientific reports · 2026Article
- Preservation of the lateral femoral circumflex artery in total hip arthroplasty using the bikini-type direct anterior approach : effect on muscle status and clinical outcomes.Bone & joint open · 2025Article
- Muscle fat infiltration: a narrative review of the magnetic resonance (MR)-based evaluation methods and their clinical applications.Quantitative imaging in medicine and surgery · 2024Review
- Abductor muscle function after anterolateral approach in patients with unilateral end-stage hip osteoarthritis undergoing total hip arthroplasty: A prospective study.Frontiers in surgery · 2023Article
- Gluteal muscle fatty infiltration, fall risk, and mobility limitation in older women with urinary incontinence: a pilot study.Skeletal radiology · 2023Article
- Imaging in Hip Arthroplasty Management Part 2: Postoperative Diagnostic Imaging Strategy.Journal of clinical medicine · 2022Review
- A novel MRI index for paraspinal muscle fatty infiltration: reliability and relation to pain and disability in lumbar spinal stenosis: results from a multicentre study.European radiology experimental · 2022Article
- Towards defining muscular regions of interest from axial magnetic resonance imaging with anatomical cross-reference: a scoping review of lateral hip musculature.BMC musculoskeletal disorders · 2022Article
- Exercise-induced muscle damage: mechanism, assessment and nutritional factors to accelerate recovery.European journal of applied physiology · 2021Review
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionFatty degeneration of the gluteal muscles on metal artefact reduction sequence (MARS) MRI has been shown to correlate with poor functional outcomes, particularly in patients with total hip arthroplasty (THA). Standardized, reliable classification systems that permit assessment of fatty gluteal infiltration are needed for clinical decision making. This study aimed to compare the reproducibility and accuracy of commonly used MRI classification systems for fatty gluteal atrophy in THA patients.
methodsMARS magnetic resonance images of 82 patients with unilateral THA were analysed by three independent trained observers. The readers evaluated fatty degeneration of the gluteus minimus, gluteus medius, and gluteus maximus according to 3 widely used classification systems: Goutallier, Quartile, and Bal and Lowe. Interobserver and intraobserver repeatability were determined using the weighted Kappa test. Quantitative evaluation of the proportion of intramuscular fat based on MR signal intensities was obtained and represented the gold standard.
resultsMean interobserver agreement for the Quartile classification system (0.93) was higher compared with Goutallier classification system (0.87) and the Bal and Lowe classification system (0.83; range 0.79-0.88; p = 0.04). Intraobserver repeatability was significantly higher for the Quartile classification system (weighted kappa 0.91, 0.89, 0.85) compared with the Bal and Lowe classification system (weighted kappa 0.83, 0.77, 0.75; p < 0.01) and Goutallier classification system (weighted kappa 0.83, 0.77, 0.75; p = 0.04). Agreement with the gold standard measurements was significantly higher in the Quartile classification system (0.88, 0.84, 0.81) compared with the Goutallier classification system (0.80, 0.77, 0.78; p = 0.02) and Bal and Lowe classification system (0.76, 0.74, 0.73; p < 0.01). DISCUSSION: This study directly compared three clinically used MRI classification systems for fatty gluteal muscle atrophy in THA patients. Our findings demonstrate that although all three classification systems demonstrate good reproducibility and accuracy, the Quartile classification system is superior to the others in terms of intraobserver reliability and accuracy to quantify fatty gluteal degeneration in THA patients.
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