Methodologies for Semiquantitative Evaluation of Hip Osteoarthritis by Magnetic Resonance Imaging: Approaches Based on the Whole Organ and Focused on Active Lesions

2013 ◽  
Vol 41 (2) ◽  
pp. 359-369 ◽  
Author(s):  
Jacob L. Jaremko ◽  
Robert G.W. Lambert ◽  
Veronika Zubler ◽  
Ulrich Weber ◽  
Damien Loeuille ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Bone Marrow ◽  
Magnetic Resonance ◽  
Scoring System ◽  
Structural Damage ◽  
Scoring Systems ◽  
Bone Marrow Lesion ◽  
Imaging Features ◽  
Resonance Imaging ◽  
Semiquantitative Assessment

Objective.As a wider variety of therapeutic options for osteoarthritis (OA) becomes available, there is an increasing need to objectively evaluate disease severity on magnetic resonance imaging (MRI). This is more technically challenging at the hip than at the knee, and as a result, few systematic scoring systems exist. The OMERACT (Outcome Measures in Rheumatology) filter of truth, discrimination, and feasibility can be used to validate image-based scoring systems. Our objective was (1) to review the imaging features relevant to the assessment of severity and progression of hip OA; and (2) to review currently used methods to grade these features in existing hip OA scoring systems.Methods.A systematic literature review was conducted. MEDLINE keyword search was performed for features of arthropathy (such as hip + bone marrow edema or lesion, synovitis, cyst, effusion, cartilage, etc.) and scoring system (hip + OA + MRI + score or grade), with a secondary manual search for additional references in the retrieved publications.Results.Findings relevant to the severity of hip OA include imaging markers associated with inflammation (bone marrow lesion, synovitis, effusion), structural damage (cartilage loss, osteophytes, subchondral cysts, labral tears), and predisposing geometric factors (hip dysplasia, femoral-acetabular impingement). Two approaches to the semiquantitative assessment of hip OA are represented by Hip OA MRI Scoring System (HOAMS), a comprehensive whole organ assessment of nearly all findings, and the Hip Inflammation MRI Scoring System (HIMRISS), which selectively scores only active lesions (bone marrow lesion, synovitis/effusion). Validation is presently confined to limited assessment of reliability.Conclusion.Two methods for semiquantitative assessment of hip OA on MRI have been described and validation according to the OMERACT Filter is limited to evaluation of reliability.

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

2019 ◽  
Vol 46 (9) ◽  
pp. 1239-1242
Author(s):  
Jacob L. Jaremko ◽  
Robert G.W. Lambert ◽  
Susanne J. Pedersen ◽  
Ulrich Weber ◽  
Duncan Lindsay ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Bone Marrow ◽  
Longitudinal Study ◽  
Magnetic Resonance ◽  
Scoring System ◽  
Steroid Injection ◽  
Intraclass Correlation ◽  
Hip Osteoarthritis ◽  
Post Injection ◽  
Resonance Imaging

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) > 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.

Erosions Are the Most Relevant Magnetic Resonance Imaging Features in Quantification of Sacroiliac Joints in Ankylosing Spondylitis

2010 ◽  
Vol 37 (3) ◽  
pp. 622-627 ◽  
Author(s):  
MARIUS C. WICK ◽  
RÜDIGER J. WEISS ◽  
WERNER JASCHKE ◽  
ANDREA S. KLAUSER
Keyword(s):  
Magnetic Resonance Imaging ◽  
Bone Marrow ◽  
Ankylosing Spondylitis ◽  
Magnetic Resonance ◽  
Contrast Medium ◽  
Rheumatic Diseases ◽  
Bone Marrow Edema ◽  
Imaging Features ◽  
Resonance Imaging ◽  
Marrow Edema

Objective.To determine the most relevant radiological features in quantitative magnetic resonance imaging (MRI) of sacroiliac (SI) joints in patients with recent-onset ankylosing spondylitis (AS) versus patients with SI involvement due to other rheumatic diseases, or to degenerative SI pain.Methods.We retrospectively analyzed laboratory values, clinical data, and MRI of the SI joints of 179 patients admitted for evaluation of AS-suspicious SI pain. Standardized MRI sequences were performed at time of first presentation, then archived, and retrospectively quantitatively assessed using a modified SPARCC method for formal statistical comparisons.Results.Of all patients, 27 (15%) were diagnosed with definite AS. The remainder had SI involvement in other rheumatic diseases, HLA-B27– spondyloarthropathy, or nonspecific degenerative changes. While joint space irregularities, bone marrow edema, subcortical cysts, and contrast medium enhancement were found in MRI of all patients, these features were inconsistent, and only erosions were statistically significantly (p < 0.02) in patients diagnosed with AS. Only in AS, the presence of erosions and the quantitative SPARCC erosion subscore correlated to a statistically significant degree (p < 0.02) with laboratory levels of inflammation.Conclusion.Erosions alone, not bone marrow edema or contrast medium enhancement, are the most disease-specific measurable imaging findings in SI MRI of patients with AS.

Development of Image Overlay and Knowledge Transfer Module Technologies Aimed at Enhancing Feasibility and External Validation of Magnetic Resonance Imaging-based Scoring Systems

2015 ◽  
Vol 43 (1) ◽  
pp. 223-231 ◽  
Author(s):  
Jacob L. Jaremko ◽  
Meaghan Pitts ◽  
Walter P. Maksymowych ◽  
Robert G. Lambert
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Knowledge Translation ◽  
Scoring System ◽  
Scoring Systems ◽  
Resonance Imaging ◽  
Training Module ◽  
Web Browser ◽  
User Training ◽  
Image Overlay

Objective.Semiquantitative arthritis scoring assesses disease burden by scoring presence/extent of features such as bone marrow lesion (BML) or effusion in multiple anatomic regions at a joint. An image overlay clarifying region borders may enhance feasibility and reliability of these scoring systems. To be scalable for use in large clinical trials, systematic computer-based user training is desirable. We developed an overlay and user training module for magnetic resonance imaging (MRI)-based scoring of hip osteoarthritis (OA).Methods.We designed a semitransparent 2-dimensional image overlay applied to individual MRI slices to facilitate hip OA scoring [HIMRISS (Hip Inflammation MRI Scoring System)], initially using freeware and then in a customized HTML Web browser environment. We developed a systematic knowledge translation package including instructional presentation, fully scored expert consensus cases, and video tutorials for training in the use of these scoring systems with the overlays. Three musculoskeletal radiologists who had not used this scoring system before each performed a scoring exercise with no overlay, then repeated this with overlays after completing the training module. Based on postexercise interviews and a reader survey, we identified and corrected problems in the module. The entire training process was then repeated using 3 new readers.Results.Overlays were considered useful, particularly when integrated into a Web browser. The knowledge translation module was considered conceptually valuable, but as initially implemented was too lengthy and not sufficiently interactive.Conclusion.Semitransparent image overlays and standardized knowledge translation modules for reader training show promise to facilitate reader calibration using MRI-based scoring systems. Based on our experience, knowledge translation modules should emphasize close feedback evaluating performance and reader time efficiency.

scholarly journals Development and Reliability of the OMERACT Thumb Base Osteoarthritis Magnetic Resonance Imaging Scoring System

2017 ◽  
Vol 44 (11) ◽  
pp. 1694-1698 ◽  
Author(s):  
Féline P.B. Kroon ◽  
Philip G. Conaghan ◽  
Violaine Foltz ◽  
Frédérique Gandjbakhch ◽  
Charles Peterfy ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Bone Marrow ◽  
Magnetic Resonance ◽  
Subchondral Bone ◽  
Scoring System ◽  
Task Force ◽  
Bone Defects ◽  
Resonance Imaging ◽  
Cross Sectional ◽  
Bone Marrow Lesions

Objective.To develop the Outcome Measures in Rheumatology (OMERACT) thumb base osteoarthritis (OA) magnetic resonance imaging (MRI) scoring system (TOMS) for the assessment of inflammatory and structural abnormalities in this hand OA subset, and test its cross-sectional reliability.Methods.Included features and their scaling were agreed upon by members of the OMERACT MRI Task Force using the Hand OA MRI scoring system as a template. A reliability exercise was performed in which 3 readers participated, using a preliminary atlas with examples to facilitate reading. Each reader independently scored a set of 20 MRI (coronal and axial T1- and T2-weighted fat-suppressed images, of which 5 included T1-weighted fat-suppressed post-Gadolinium images). Intra- and inter-reader reliability were assessed using ICC, percentage exact agreement (PEA), and percentage close agreement (PCA).Results.The TOMS assessed the first carpometacarpal (CMC-1) and scaphotrapeziotrapezoid (STT) joints for synovitis, subchondral bone defects (including erosions, cysts, and bone attrition), osteophytes, cartilage, and bone marrow lesions on a 0–3 scale (normal to severe). Subluxation was evaluated only in the CMC-1 joint (absent/present). Reliability of scoring for both joints was comparable. Interreader ICC were good for all features (0.77–0.99 and 0.74–0.96 for CMC-1 and STT joints, respectively). Intrareader reliability analyses gave similar results. PCA was ≥ 65% for all features. PEA was low to moderate, with better performance for subchondral bone defects, subluxation, and bone marrow lesions.Conclusion.A thumb base OA MRI scoring system has been developed. The OMERACT TOMS demonstrated good intrareader and interreader reliability. Longitudinal studies are warranted to investigate reliability of change scores and responsiveness.

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