Jill Halstead1,2, Carmen Martín-Hervás1,2, Elizabeth M A Hensor1,2, Dennis McGonagle1,2, Anne-Maree Keenan1,2, Anthony C Redmond3,4, Philip G Conaghan1,2. 1. From the Leeds Institute of Rheumatic and Musculoskeletal Medicine, and the School of Healthcare, University of Leeds; UK National Institute for Health Research (NIHR) Biomedical Research Centre, Leeds Teaching Hospitals Trust, Leeds; Arthritis Research UK Experimental Osteoarthritis Treatment Centre, Leeds; Arthritis Research UK Centre for Sports, Exercise and Osteoarthritis, Nottingham/Leeds; Salford Royal Hospital UK National Health Service (NHS) Foundation Trust, Manchester, UK; Department of Musculoskeletal Radiology, La Paz University Hospital, Autonomous University of Madrid; Biomedical Research Networking Centre on Bioengineering, Biomaterials and Nanomedicine, Madrid, Spain. 2. J. Halstead, PhD, Visiting Research Fellow, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and Principal Podiatrist, Salford Royal Hospital NHS Foundation Trust; C. Martín-Hervás, PhD, MD, Consultant Radiologist, Department of Musculoskeletal Radiology, La Paz University Hospital, and Associate Professor of Radiology, School of Medicine, Autonomous University of Madrid, and Biomedical Research Networking Centre on Bioengineering, Biomaterials and Nanomedicine; E.M. Hensor, PhD, Biostatistician, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust; D. McGonagle, PhD, Professor of Investigative Rheumatology, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust; A.M. Keenan, PhD, Professor of Allied Health Research, School of Healthcare, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, and Arthritis Research UK Experimental Osteoarthritis Treatment Centre; A.C. Redmond, PhD, Professor of Clinical Biomechanics, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, and Arthritis Research UK Experimental Osteoarthritis Treatment Centre, and Arthritis Research UK Centre for Sports, Exercise and Osteoarthritis; P.G. Conaghan, PhD, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, and Arthritis Research UK Experimental Osteoarthritis Treatment Centre, and Arthritis Research UK Centre for Sports, Exercise and Osteoarthritis. P.G. Conaghan and A.C. Redmond contributed equally to this study. 3. From the Leeds Institute of Rheumatic and Musculoskeletal Medicine, and the School of Healthcare, University of Leeds; UK National Institute for Health Research (NIHR) Biomedical Research Centre, Leeds Teaching Hospitals Trust, Leeds; Arthritis Research UK Experimental Osteoarthritis Treatment Centre, Leeds; Arthritis Research UK Centre for Sports, Exercise and Osteoarthritis, Nottingham/Leeds; Salford Royal Hospital UK National Health Service (NHS) Foundation Trust, Manchester, UK; Department of Musculoskeletal Radiology, La Paz University Hospital, Autonomous University of Madrid; Biomedical Research Networking Centre on Bioengineering, Biomaterials and Nanomedicine, Madrid, Spain. a.redmond@leeds.ac.uk. 4. J. Halstead, PhD, Visiting Research Fellow, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and Principal Podiatrist, Salford Royal Hospital NHS Foundation Trust; C. Martín-Hervás, PhD, MD, Consultant Radiologist, Department of Musculoskeletal Radiology, La Paz University Hospital, and Associate Professor of Radiology, School of Medicine, Autonomous University of Madrid, and Biomedical Research Networking Centre on Bioengineering, Biomaterials and Nanomedicine; E.M. Hensor, PhD, Biostatistician, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust; D. McGonagle, PhD, Professor of Investigative Rheumatology, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust; A.M. Keenan, PhD, Professor of Allied Health Research, School of Healthcare, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, and Arthritis Research UK Experimental Osteoarthritis Treatment Centre; A.C. Redmond, PhD, Professor of Clinical Biomechanics, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, and Arthritis Research UK Experimental Osteoarthritis Treatment Centre, and Arthritis Research UK Centre for Sports, Exercise and Osteoarthritis; P.G. Conaghan, PhD, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, and Arthritis Research UK Experimental Osteoarthritis Treatment Centre, and Arthritis Research UK Centre for Sports, Exercise and Osteoarthritis. P.G. Conaghan and A.C. Redmond contributed equally to this study. a.redmond@leeds.ac.uk.
Abstract
OBJECTIVE: Foot osteoarthritis (OA) is very common but underinvestigated musculoskeletal condition and there is little consensus as to common magnetic resonance imaging (MRI) features. The aim of this study was to develop a preliminary foot OA MRI score (FOAMRIS) and evaluate its reliability. METHODS: This preliminary semiquantitative score included the hindfoot, midfoot, and metatarsophalangeal joints. Joints were scored for joint space narrowing (JSN; 0-3), osteophytes (0-3), joint effusion/synovitis, and bone cysts (present/absent). Erosions and bone marrow lesions (BML) were scored (0-3) and BML were evaluated adjacent to entheses and at sub-tendon sites (present/absent). Additionally, tenosynovitis (0-3) and midfoot ligament pathology (present/absent) were scored. Reliability was evaluated in 15 people with foot pain and MRI-detected OA using 3.0T MRI multi-sequence protocols, and assessed using ICC as an overall score and per anatomical site. RESULTS: Intrareader agreement (ICC) was generally good to excellent across the foot in joint features (JSN 0.90, osteophytes 0.90, effusion/synovitis 0.46, cysts 0.87), bone features (BML 0.83, erosion 0.66, BML entheses 0.66, BML sub-tendon 0.60) and soft tissue features (tenosynovitis 0.83, ligaments 0.77). Interreader agreement was lower for joint features (JSN 0.43, osteophytes 0.27, effusion/synovitis 0.02, cysts 0.48), bone features (BML 0.68, erosion 0.00, BML entheses 0.34, BML sub-tendon 0.13), and soft tissue features (tenosynovitis 0.35, ligaments 0.33). CONCLUSION: This preliminary FOAMRIS demonstrated good intrareader reliability and fair interreader reliability when assessing the total feature scores. Further development is required in cohorts with a range of pathologies and to assess the psychometric measurement properties.
OBJECTIVE:Foot osteoarthritis (OA) is very common but underinvestigated musculoskeletal condition and there is little consensus as to common magnetic resonance imaging (MRI) features. The aim of this study was to develop a preliminary foot OA MRI score (FOAMRIS) and evaluate its reliability. METHODS: This preliminary semiquantitative score included the hindfoot, midfoot, and metatarsophalangeal joints. Joints were scored for joint space narrowing (JSN; 0-3), osteophytes (0-3), joint effusion/synovitis, and bone cysts (present/absent). Erosions and bone marrow lesions (BML) were scored (0-3) and BML were evaluated adjacent to entheses and at sub-tendon sites (present/absent). Additionally, tenosynovitis (0-3) and midfoot ligament pathology (present/absent) were scored. Reliability was evaluated in 15 people with foot pain and MRI-detected OA using 3.0T MRI multi-sequence protocols, and assessed using ICC as an overall score and per anatomical site. RESULTS: Intrareader agreement (ICC) was generally good to excellent across the foot in joint features (JSN 0.90, osteophytes 0.90, effusion/synovitis 0.46, cysts 0.87), bone features (BML 0.83, erosion 0.66, BML entheses 0.66, BML sub-tendon 0.60) and soft tissue features (tenosynovitis 0.83, ligaments 0.77). Interreader agreement was lower for joint features (JSN 0.43, osteophytes 0.27, effusion/synovitis 0.02, cysts 0.48), bone features (BML 0.68, erosion 0.00, BML entheses 0.34, BML sub-tendon 0.13), and soft tissue features (tenosynovitis 0.35, ligaments 0.33). CONCLUSION: This preliminary FOAMRIS demonstrated good intrareader reliability and fair interreader reliability when assessing the total feature scores. Further development is required in cohorts with a range of pathologies and to assess the psychometric measurement properties.
Entities:
Keywords:
FOOT; MAGNETIC RESONANCE IMAGING; OSTEOARTHRITIS; RELIABILITY; SEMIQUANTITATIVE SCORE
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