Foot Osteoarthritis Magnetic Resonance Imaging Score

NewsBot · Jun 3, 2017

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Development and Reliability of a Preliminary Foot Osteoarthritis Magnetic Resonance Imaging Score.
Halstead J et al
J Rheumatol. 2017 Jun 1. pii: jrheum.160617. doi: 10.3899/jrheum.160617.

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 multisequence 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.
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NewsBot · Apr 1, 2019

OMERACT agreement and reliability study of ultrasonographic elementary lesions in osteoarthritis of the foot
Alen Zabotti et al
RMD Open 2019;5:e000795. doi: 10.1136/rmdopen-2018-000795

Objective To evaluate the level of agreement on ultrasonographic (US) lesions among highly experienced sonographers as well as the intraobserver and interobserver reliability of inflammatory and structural US lesions in patients with osteoarthritis (OA) of the foot.

Methods After a systematic literature review, a Delphi survey was performed to test definitions of US lesions in OA of the foot, including inflammatory lesions (ie, synovial hypertrophy [SH], joint effusion [JE], power Doppler signal [PD]), and structural abnormalities (ie, cartilage damage [CD] and osteophytes). Subsequently, the reliability of US in assessing the aforementioned lesions was tested on static images as well as during a live exercise. Reliability was assessed by kappa analyses and prevalence-adjusted bias-adjusted kappa (PABAK) on a dichotomous and an ordinal scale.

Results Intraobserver and interobserver reliability for SH and JE evaluated by binary scoring was good for both components, while the intraobserver reliability for semiquantitative scoring of SH ranged from moderate in the web-based exercise (PABAK 0.49) to good (PABAK 0.8) in the live exercise. Reliability for CD and PD assessments were respectively good and excellent in all exercises (ranged from PABAK 0.61 to 0.79 for CD and 0.88 to 0.95 for PD). The interobserver reliability for the semiquantitative scoring of osteophytes was fair in the live exercise (PABAK 0.36) and moderate in the static exercise (PABAK 0.60).

Conclusions Consensual US definitions were found to be reliable for assessing inflammatory lesions in OA of the foot, while the use of US to assess structural damage requires further studies.
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NewsBot · Jun 26, 2019

Development and reproducibility of a first metatarsophalangeal joint osteoarthritis magnetic resonance imaging scoring system.
Munteanu SE et al
Arthritis Care Res (Hoboken). 2019 Jun 24

OBJECTIVE:
To develop a magnetic resonance imaging (MRI) atlas for the assessment of osteoarthritis (OA) of the first metatarsophalangeal joint (1st MTPJ), and to assess its intra- and inter-examiner reproducibility.

METHODS:
MRI (proton density with and without fat suppression) was performed on the 1st MTPJ of 60 participants (30 with and 30 without 1st MTPJ OA). Characteristic MRI features of OA were then used to develop an MRI atlas of 1st MTPJ OA. The atlas assessed osteophytes (dorsal metatarsal head, plantar metatarsal head, dorsal proximal phalanx), bone marrow lesions (metatarsal head, proximal phalanx, sesamoids), cysts (metatarsal head, proximal phalanx), effusion-synovitis (dorsal, plantar), joint space narrowing (metatarsal-proximal phalanx, metatarsal-sesamoids) and cartilage loss. To assess the reproducibility of the atlas, two examiners independently rated the MRIs of 30 participants on two occasions. Intra- and inter-examiner reproducibility were determined using percentage agreement and Gwet's AC1.

RESULTS:
Observations using the atlas demonstrated fair to perfect intra-examiner reproducibility (percentage agreement from 67 to 100% and Gwet's AC1 from 0.38 to 1.00), and fair to almost perfect inter-examiner reproducibility (percentage agreement from 67 to 98% and Gwet's AC1 from 0.40 to 0.96).

CONCLUSION:
A MRI scoring system for the assessment of osteoarthritis of the 1st MTPJ has been developed. The atlas demonstrates excellent intra- and inter-examiner reproducibility. The atlas has the potential to allow for a better understanding of the cause(s) of pain in 1st MTPJ OA.
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NewsBot · May 22, 2022

A bibliometric analysis of published research employing musculoskeletal imaging modalities to evaluate foot osteoarthritis
Prue Molyneux, Sarah Stewart, Catherine Bowen, Richard Ellis, Keith Rome & Matthew Carroll
Journal of Foot and Ankle Research volume 15, Article number: 39 (2022)

Objectives
Temporal and global changes in research utilising imaging to assess foot osteoarthritis is currently unknown. This study aimed to undertake a bibliometric analysis of published research to: (1) identify the imaging modalities that have been used to evaluate foot osteoarthritis; (2) explore the temporal changes and global differences in the use of these imaging modalities; and (3) to evaluate performance related to publication- and citation-based metrics.

Methods
A literature search was conducted using Scopus to identify studies which had used imaging to assess foot osteoarthritis. Extracted data included publication year, imaging modality, citations, affiliations, and author collaboration networks. Temporal trends in the use of each imaging modality were analysed. Performance analysis and science mapping were used to analyse citations and collaboration networks.

Results
158 studies were identified between 1980 and 2021. Plain radiography was the most widely used modality, followed by computed tomography, magnetic resonance imaging (MRI) and ultrasound imaging (USI), respectively. The number of published studies increased over time for each imaging modality (all P ≥ 0.018). The most productive country was the United States of America (USA), followed by the United Kingdom and Australia. International authorship collaboration was evident in 57 (36.1%) studies. The average citation rate was 23.4 per study, with an average annual citation rate of 2.1.

Conclusions
Published research employing imaging to assess foot osteoarthritis has increased substantially over the past four decades. Although plain radiography remains the gold standard modality, the emergence of MRI and USI in the past two decades continues to advance knowledge and progress research in this field.
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NewsBot · Apr 19, 2024

Reliability of an ultrasound imaging acquisition procedure for examining osteoarthritis in the first metatarsophalangeal joint
Prue Molyneux et al
J Foot Ankle Res. 2024 Mar;17(1):e12002

Objective: Given the ability of ultrasound imaging (USI) to depict tissue-specific morphological changes before the onset of pain and before the point of irreversible structural damage, USI could play a fundamental role in earlier detection and assessment of foot osteoarthritis (OA). The current guidelines require further refinement of anatomical landmarks to establish a standardized imaging procedure to improve the interpretability and reproducibility between studies evaluating the first metatarsophalangeal joint (MTPJ). The aims were to develop an USI acquisition procedure and grading system to examine OA features in the first MTPJ and to determine intra-examiner and inter-examiner reliability of a newly developed USI acquisition procedure.

Design: Thirty participants with first MTPJ OA confirmed radiographically with the use of the La Trobe Foot Atlas were included. An experienced sonographer applied a newly developed USI procedure to examine the following features: joint effusion, synovial hypertrophy, synovitis, joint space narrowing, osteophytes, and cartilage thickness. A semiquantitative grading system was applied to all features. A continuous measure was also examined for osteophyte size, joint space narrowing, and cartilage thickness. To determine the intra-examiner and inter-examiner reliability, an experienced radiologist and sonographer applied the developed grading system to the images acquired from two imaging sessions. Intra-examiner and inter-examiner reliability were calculated using intraclass correlation coefficients (ICCs).

Results: ICCs for intra-examiner between session reliability ranged from 0.58 to 0.92 for semiquantitative grading and 0.39 to 0.94 for continuous measures. Joint effusion and osteophytes achieved the highest intra-examiner reliability (ICC = 0.78-0.94). ICCs for session one inter-examiner reliability ranged from 0.61 to 1.0 for semiquantitative grading; all continuous measures had an ICC of 1. ICCs for session two inter-examiner reliability ranged from 0.55 to 1.0 for semiquantitative grading and 0.9 to 0.97 for continuous measures. Inter-examiner reliability was good for grading joint effusion (ICC = 0.55-0.62) and was excellent for all other USI features (ICC = 0.77-1.0).

Conclusion: The USI acquisition procedure and grading system are reliable in evaluating first MTPJ OA features in participants with radiologically confirmed OA. The study will inform the methodological development of an ultrasound atlas for grading the degree of osteoarthritic change in the first MTPJ.
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