RT Journal Article
SR Electronic
T1 Magnetic Resonance Imaging in Hand Osteoarthritis: Intraobserver Reliability and Criterion Validity for Clinical and Structural Characteristics
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP jrheum.140338
DO 10.3899/jrheum.140338
A1 Marion C.  Kortekaas
A1 Wing-Yee Kwok
A1 Monique Reijnierse
A1 Ron Wolterbeek
A1 Pernille Bøyesen
A1 Desiree van der Heijde
A1 Johannes L.  Bloem
A1 Margreet Kloppenburg
YR 2015
UL http://www.jrheum.org/content/early/2015/05/11/jrheum.140338.abstract
AB Objective To investigate criterion validity and intraobserver reliability of magnetic resonance imaging (MRI) in hand osteoarthritis (HOA). Methods In 16 patients with HOA (median age 57 yrs, 62% women, 13 with erosive OA), 3 Tesla MRI scans with gadolinium-chelate administration of right second to fifth distal interphalangeal/proximal interphalangeal joints were scored according to the Oslo HOA scoring method for synovial thickening, bone marrow lesions (BML), osteophytes, joint space narrowing (JSN), and erosions (grade 0–3). Ultrasound (US) was scored for synovial thickening and osteophytes, radiographs for osteophytes and JSN (Osteoarthritis Research Society International score), and anatomical phases (Verbruggen-Veys score). Pain was assessed during physical examination. Correlations of MRI with US and radiographic features were assessed with generalizability theory. With generalized estimating equations analyses, MRI features were associated with pain, adjusting for confounding. Results Forty-three percent, 27%, 77%, and 61% of joints had synovial thickening (moderate/severe), BML, osteophytes, and erosions on MRI, respectively. Intraobserver reliability, assessed in 6 patients, was good (ICC 0.77–1.00). Correlations between osteophytes, JSN, and erosions on radiographs and MRI were moderate, substantial, and fair (ICC 0.53, 0.68, and 0.32, respectively); MRI showed more lesions than radiography. Correlation between synovial thickening and osteophytes on MRI and US was moderate (ICC 0.43 and 0.49, respectively). MRI was more sensitive for synovial thickening, US for osteophytes. Pain was associated with moderate/severe synovial thickening (adjusted OR 2.4, 95% CI 1.06–5.5), collateral ligaments (4.2, 2.2–8.3), BML (3.5, 1.6–7.7), erosions (4.5, 1.7–12.2), and osteophytes (2.4, 1.1–5.2). Conclusion MRI is a reliable and valid method to assess inflammatory and structural features in HOA. It gives additional information over radiographs and US.