Document Detail


Development and Preliminary Validation of a Magnetic Resonance Imaging Joint Space Narrowing Score for Use in Rheumatoid Arthritis: Potential Adjunct to the OMERACT RA MRI Scoring System.
MedLine Citation:
PMID:  21885515     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVE: To develop and validate a magnetic resonance imaging (MRI) method of assessment of joint space narrowing (JSN) in rheumatoid arthritis (RA).
METHODS: Phase A: JSN was scored 0-4 on MR images of 5 RA patients and 3 controls at 15 wrist sites and 2nd-5th metacarpophalangeal (MCP) joints by 8 readers (7 once, one twice), using a preliminary scoring system. Phase B: Image review, discussion, and consensus on JSN definition, and revised scoring system. Phase C: MR images of 15 RA patients and 4 controls were scored using revised system by 5 readers (4 once, one twice), and results compared with radiographs [Sharp-van der Heijde (SvdH) method].
RESULTS: Phase A: Intraobserver agreement: intraclass correlation coefficient (ICC) = 0.99; smallest detectable difference (SDD, for mean of readings) = 2.8 JSN units (4.9% of observed maximal score). Interobserver agreement: ICC = 0.93; SDD = 6.4 JSN units (9.9%). Phase B: Agreement was reached on JSN definition (reduced joint space width compared to normal, as assessed in a slice perpendicular to the joint surface), and revised scoring system (0-4 at 17 wrist sites and 2nd-5th MCP; 0: none; 1: 1-33%; 2: 34-66%; 3: 67-99%; 4: ankylosis). Phase C: Intraobserver agreement: ICC = 0.90; SDD = 6.8 JSN units (11.0%). Interobserver agreement: ICC = 0.92 and SDD = 6.2 JSN units (8.7%). The correlation (ICC) with the SvdH radiographic JSN score of the wrist/hand was 0.77. Simplified approaches evaluating fewer joint spaces demonstrated similar reliability and correlation with radiographic scores.
CONCLUSION: An MRI scoring system of JSN in RA wrist and MCP joints was developed and showed construct validity and good intra- and interreader agreements. The system may, after further validation in longitudinal data sets, be useful as an outcome measure in RA.
Authors:
Mikkel Ostergaard; Pernille Bøyesen; Iris Eshed; Frédérique Gandjbakhch; Siri Lillegraven; Paul Bird; Violaine Foltz; Annelies Boonen; Marissa Lassere; Kay-Geert Hermann; Allen Anandarajah; Uffe Møller Døhn; Jane Freeston; Charles G Peterfy; Harry K Genant; Espen A Haavardsholm; Fiona M McQueen; Philip G Conaghan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of rheumatology     Volume:  38     ISSN:  0315-162X     ISO Abbreviation:  J. Rheumatol.     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-09-02     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7501984     Medline TA:  J Rheumatol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  2045-50     Citation Subset:  IM    
Affiliation:
mo@dadlnet.dk.
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