Validation of the OMERACT Magnetic Resonance Imaging Joint Space Narrowing Score for the Wrist in a Multireader Longitudinal Trial

2015 ◽  
Vol 42 (12) ◽  
pp. 2480-2485 ◽  
Author(s):  
Daniel Glinatsi ◽  
Siri Lillegraven ◽  
Espen A. Haavardsholm ◽  
Iris Eshed ◽  
Philip G. Conaghan ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Joint Space Narrowing ◽  
Intraclass Correlation ◽  
Joint Space ◽  
Sensitivity To Change ◽  
Resonance Imaging ◽  
Change Scores ◽  
Smallest Detectable Change

Objective.To assess the intrareader and interreader agreement and sensitivity to change of the Outcome Measures in Rheumatology (OMERACT) Rheumatoid Arthritis Magnetic Resonance Imaging Joint Space Narrowing (RAMRIS-JSN) score in the rheumatoid arthritis (RA) wrist in a longitudinal multireader exercise.MethodsCoronal T1-weighted MR image sets of 1 wrist from 20 patients with early RA were assessed twice for JSN at 17 sites at baseline and after 36 or 60 months by 4 readers blinded to patient data but not time order. The joints were scored 0–4 according to the OMERACT RAMRIS-JSN score. Intraclass correlation coefficients (ICC), smallest detectable change (SDC), percentage exact/close agreement (PEA/PCA), and standardized response mean (SRM) were calculated.Results.Median baseline and change score was 10.3 and 1.9, respectively. Intrareader ICC for baseline and change scores was good (≥ 0.50) to very good (≥ 0.80) for all and 3 of 4 readers, respectively. Interreader ICC was very good for change (0.93), while poor for baseline score if all 4 readers were included (0.36), but very good if 1 reader was excluded (0.87). Intrareader and interreader SDC was low (2.34–3.18), except for the intrareader SDC for 1 reader (6.75). The mean PEA/PCA was high for baseline and change scores both within and between the readers (51.5–99.2), except for interreader baseline PEA (14.4). SRM was moderate for all readers (0.55–0.77).Conclusion.The OMERACT RAMRIS-JSN score showed high overall intrareader and interreader reliability, and moderate sensitivity to change, supporting inclusion of the measure as part of the OMERACT RAMRIS system.

The OMERACT-RAMRIS Rheumatoid Arthritis Magnetic Resonance Imaging Joint Space Narrowing Score: Intrareader and Interreader Reliability and Agreement with Computed Tomography and Conventional Radiography

2013 ◽  
Vol 41 (2) ◽  
pp. 392-397 ◽  
Author(s):  
Uffe Møller Døhn ◽  
Philip G. Conaghan ◽  
Iris Eshed ◽  
Annelies Boonen ◽  
Pernille Boyesen ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Joint Space Narrowing ◽  
Intraclass Correlation ◽  
Joint Space ◽  
Imaging Data ◽  
Resonance Imaging ◽  
Scoring Method

Objective.To test the intrareader and interreader reliability of assessment of joint space narrowing (JSN) in rheumatoid arthritis (RA) wrist and metacarpophalangeal (MCP) joints on magnetic resonance imaging (MRI) and computed tomography (CT) using the newly proposed OMERACT-RAMRIS JSN scoring method, and to compare JSN assessment on MRI, CT, and radiography.Methods.After calibration of readers, MRI and CT images of the wrist and second to fifth MCP joints from 14 patients with RA and 1 healthy control were assessed twice for JSN by 3 readers, blinded to clinical and imaging data. Radiographs were scored by the Sharp/van der Heijde method. Intraclass correlation coefficients (ICC) and smallest detectable differences (SDD) were calculated, and the performance of various simplified scores was investigated.Results.Both MRI and CT showed high intrareader (ICC ≥ 0.95) and interreader (ICC ≥ 0.94) reliability for total (wrist + MCP) assessment of JSN. Agreement was generally lower for MCP joints than for wrist joints, particularly for CT. Intrareader SDD for MCP/wrist/MCP + wrist were 1.2/6.1/6.4 JSN units for MRI, while 2.7/8.3/9.9 JSN units for CT. JSN on MRI and CT correlated moderately well with corresponding radiographic JSN scores (MCP 2–5: 0.49 and 0.56; wrist areas assessed by Sharp/van der Heijde: 0.80 and 0.95), and high ICC between scores on MRI and CT were demonstrated (MCP: 0.94; wrist: 0.92; MCP + wrist: 0.92).Conclusion.The OMERACT-RAMRIS MRI JSN scoring system showed high intrareader and interreader reliability, and high correlation with CT scores of JSN. The suggested JSN score may, after further validation in longitudinal studies, become a useful tool in RA clinical trials.

scholarly journals Reliability of Magnetic Resonance Imaging (MRI) Scoring of the Metatarsophalangeal Joints of the Foot according to the Rheumatoid Arthritis MRI Score

2019 ◽  
Vol 47 (8) ◽  
pp. 1165-1173 ◽  
Author(s):  
Yousra J. Dakkak ◽  
Xanthe M.E. Matthijssen ◽  
Désirée van der Heijde ◽  
Monique Reijnierse ◽  
Annette H.M. van der Helm-van Mil
Keyword(s):  
Rheumatoid Arthritis ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Intraclass Correlation ◽  
Early Arthritis ◽  
Systematic Bias ◽  
Resonance Imaging ◽  
Smallest Detectable Change ◽  
Mtp Joints ◽  
Wrist Joints

Objective.The Rheumatoid Arthritis Magnetic Resonance Imaging Score (RAMRIS) is validated for hand MRI. Its reliability applied to metatarsophalangeal (MTP 1–5) joints is unknown and was studied in early arthritis and clinically suspect arthralgia.Methods.Patients underwent 1.5 Tesla MRI of MTP, metacarpophalangeal (MCP 2–5), and wrist joints. Two paired readers scored bone marrow edema (BME), synovitis, tenosynovitis, and erosions. Interreader reliability was assessed of 441 consecutive early arthritis patients at baseline, 215 by 2 readers, and the remaining 226 by 2 different readers. Two readers scored baseline MRI of 82 consecutive patients with clinically suspect arthralgia, and 40 randomly selected patients by 9 readers. Intrareader reliability was determined on a random set of 15 early arthritis patients, scored twice by 2 readers. For change scores, 30 early arthritis patients with baseline and 1-year followup MRI were scored by 2 readers. Intraclass correlation coefficients (ICC), Bland-Altman (BA) plots, and smallest detectable change (SDC) were determined. MRI data of MTP joints were compared to wrist and MCP joints.Results.Interreader ICC and mean scores in early arthritis were BME ICC 0.91–0.92 (mean 1.5 ± SD 2.6), synovitis 0.90–0.92 (1.3 ± 1.7), tenosynovitis 0.80–0.85 (1.1 ± 1.8), and erosions 0.88–0.89 (0.7 ± 1.0). In patients with clinically suspect arthralgia, ICC were comparable. Intrareader ICC for inflammatory MRI features were 0.84–0.98, for erosions 0.71 (reader 1), and 0.92 (reader 2). Change score ICC were ≥ 0.90, except erosions (0.77). SDC were ≤ 1.0. BA plots showed no systematic bias. Reliability scores of MTP joints were similar to MCP and wrist joints.Conclusion.Status and change MRI scores of BME, synovitis, tenosynovitis, and erosions of MTP joints can be assessed reliably by RAMRIS.

scholarly journals The OMERACT Rheumatoid Arthritis Magnetic Resonance Imaging (MRI) Scoring System: Updated Recommendations by the OMERACT MRI in Arthritis Working Group

2017 ◽  
Vol 44 (11) ◽  
pp. 1706-1712 ◽  
Author(s):  
Mikkel Østergaard ◽  
Charles G. Peterfy ◽  
Paul Bird ◽  
Frédérique Gandjbakhch ◽  
Daniel Glinatsi ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Working Group ◽  
Scoring System ◽  
Research Agenda ◽  
Image Resolution ◽  
Sensitivity To Change ◽  
Resonance Imaging ◽  
Magnetic Resonance Imaging Mri

Objective.The Outcome Measures in Rheumatology (OMERACT) Rheumatoid Arthritis (RA) Magnetic Resonance Imaging (MRI) scoring system (RAMRIS), evaluating bone erosion, bone marrow edema/osteitis, and synovitis, was introduced in 2002, and is now the standard method of objectively quantifying inflammation and damage by MRI in RA trials. The objective of this paper was to identify subsequent advances and based on them, to provide updated recommendations for the RAMRIS.Methods.MRI studies relevant for RAMRIS and technical and scientific advances were analyzed by the OMERACT MRI in Arthritis Working Group, which used these data to provide updated considerations on image acquisition, RAMRIS definitions, and scoring systems for the original and new RA pathologies. Further, a research agenda was outlined.Results.Since 2002, longitudinal studies and clinical trials have documented RAMRIS variables to have face, construct, and criterion validity; high reliability and sensitivity to change; and the ability to discriminate between therapies. This has enabled RAMRIS to demonstrate inhibition of structural damage progression with fewer patients and shorter followup times than has been possible with conventional radiography. Technical improvements, including higher field strengths and improved pulse sequences, allow higher image resolution and contrast-to-noise ratio. These have facilitated development and validation of scoring methods of new pathologies: joint space narrowing and tenosynovitis. These have high reproducibility and moderate sensitivity to change, and can be added to RAMRIS. Combined scores of inflammation or joint damage may increase sensitivity to change and discriminative power. However, this requires further research.Conclusion.Updated 2016 RAMRIS recommendations and a research agenda were developed.

Hand Joint Space Narrowing and Osteophytes Are Associated with Magnetic Resonance Imaging-defined Knee Cartilage Thickness and Radiographic Knee Osteoarthritis: Data from the Osteoarthritis Initiative

2011 ◽  
Vol 39 (1) ◽  
pp. 161-166 ◽  
Author(s):  
IDA K. HAUGEN ◽  
SEBASTIAN COTOFANA ◽  
MARTIN ENGLUND ◽  
TORE K. KVIEN ◽  
DONATUS DREHER ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Joint Space Narrowing ◽  
Joint Space ◽  
Cartilage Thickness ◽  
Resonance Imaging ◽  
Knee Cartilage ◽  
Knee Oa ◽  
Osteoarthritis Initiative ◽  
Hand Radiographs

Objective.To evaluate whether features of radiographic hand osteoarthritis (OA) are associated with quantitative magnetic resonance imaging (MRI)-defined knee cartilage thickness, radiographic knee OA, and 1-year structural progression.Methods.A total of 765 participants in Osteoarthritis Initiative (OAI; 455 women, mean age 62.5 yrs, SD 9.4) obtained hand radiographs (at baseline), knee radiographs (baseline and Year 1), and knee MRI (baseline and Year 1). Hand radiographs were scored for presence of osteophytes and joint space narrowing (JSN). Knee radiographs were scored according to the Kellgren-Lawrence (KL) scale. Cartilage thickness in the medial and lateral femorotibial compartments was measured quantitatively from coronal FLASHwe images. We examined the cross-sectional and longitudinal associations between features of hand OA (total osteophyte and JSN scores) and knee cartilage thickness, 1-year knee cartilage thinning (above smallest detectable change), presence of knee OA (KL grade ≥ 3), and progression of knee OA (KL change ≥ 1) by linear and logistic regression. Both hand OA features were included in a multivariate model (if p ≤ 0.25) adjusted for age, sex, and body mass index (BMI).Results.Hand JSN was associated with reduced knee cartilage thickness (ß = −0.02, 95% CI −0.03, −0.01) in the medial femorotibial compartment, while hand osteophytes were associated with the presence of radiographic knee OA (OR 1.10, 95% CI 1.03–1.18; multivariate models) with both hand OA features as independent variables adjusted for age, sex, and BMI). Radiographic features of hand OA were not associated with 1-year cartilage thinning or radiographic knee OA progression.Conclusion.Our results support a systemic OA susceptibility and possibly different mechanisms for osteophyte formation and cartilage thinning.

scholarly journals Effect of the Inclusion of the Metacarpophalangeal Joints on the Wrist Magnetic Resonance Imaging Scoring System in Juvenile Idiopathic Arthritis

2018 ◽  
Vol 45 (11) ◽  
pp. 1581-1587 ◽  
Author(s):  
E.H. Pieter van Dijkhuizen ◽  
Federica Vanoni ◽  
Gian Michele Magnano ◽  
Francesca Magnaguagno ◽  
Karen Rosendahl ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Juvenile Idiopathic Arthritis ◽  
Magnetic Resonance ◽  
Disease Activity ◽  
Intraclass Correlation ◽  
Sensitivity To Change ◽  
Resonance Imaging ◽  
Clinical Variables ◽  
Metric Properties ◽  
Carpometacarpal Joints

Objective.To extend the magnetic resonance imaging (MRI) score for assessment of wrist synovitis in juvenile idiopathic arthritis (JIA) by inclusion of the metacarpophalangeal (MCP) joints, and to compare the metric properties of the original and the extended score.Methods.Wrist MRI of 70 patients with JIA were scored by 3 independent readers according to (1) the wrist component of the rheumatoid arthritis MRI synovitis score (comprising distal radioulnar, radiocarpal, and combined midcarpal and carpometacarpal joints); and (2) an extended score including the MCP joints. Thirty-eight patients had a 1-year MRI followup. The concordance between the readers [intraclass correlation coefficient (ICC), 95% limits of agreement (LOA), and weighted Cohen’s κ], correlations with clinical variables (Spearman’s ϱ), and the sensitivity to change [standardized response mean (SRM)] were calculated for both scores.Results.The interreader agreement was moderate for the original score (ICC 0.77; 95% CI 0.68–0.84) and good for the extended score (ICC 0.86; 95% CI 0.80–0.91). Using 95% LOA, the aggregate score variability was less favorable with relatively wide LOA. Weighted Cohen’s κ of the individual joints indicated good agreement for the original score and good to excellent agreement for the extended score. Correlations with clinical variables reflecting disease activity improved for the extended score and its SRM was higher compared to that of the original score.Conclusion.The extended score showed better reliability, construct validity, and sensitivity to change than the original. Inclusion of the MCP joints should be considered for a more accurate assessment of disease activity and treatment efficacy in JIA.

Reliability and sensitivity to change of the OMERACT rheumatoid arthritis magnetic resonance imaging score in a multireader, longitudinal setting

2005 ◽  
Vol 52 (12) ◽  
pp. 3860-3867 ◽  
Author(s):  
Espen A. Haavardsholm ◽  
Mikkel Østergaard ◽  
Bo J. Ejbjerg ◽  
Nils P. Kvan ◽  
Till A. Uhlig ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Sensitivity To Change ◽  
Resonance Imaging
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