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Objective.  To assess reliability, feasibility, and responsiveness of Hip Inflammation Magnetic resonance imaging Scoring System (HIMRISS) for bone marrow lesions (BML) in hip osteoarthritis (OA).    Methods.  HIMRISS was scored by 8 readers in 360 hips of 90 patients imaged pre/post-hip steroid injection. Pre-scoring, new readers trained online to achieve intraclass correlation coefficient (ICC) &gt; 0.80 versus experts.    Results.  HIMRISS reliability was excellent for BML status (ICC 0.83–0.92). Despite small changes post-injection, reliability of BML change scores was high in femur (0.76–0.81) and moderate in acetabulum (0.42–0.56).    Conclusion.  HIMRISS should be a priority for further assessment of hip BML in OA, and evaluated for use in other arthropathies.

OMERACT Hip Inflammation Magnetic Resonance Imaging Scoring System (HIMRISS) Assessment in Longitudinal Study