Article Figures & Data
Figures
- Figure 1.
Magnetic resonance imaging examples of PsAMRIS’s sensitivity to change during anti-TNF-α treatment. The T1-weighted images show before (A and B) and after (C and D) gadolinium injection. Baseline MR images of PIP-3 (A and B) show periarticular inflammation (broad arrow, B) and synovitis (narrow arrow, B). After 12 months with anti-TNF-α treatment (C and D) the periarticular inflammation and synovitis of the PIP-3 resolved.
Tables
- Table 1.
Patients included in the Psoriatic Arthritis Magnetic Resonance Imaging Score (PsAMRIS) workshop.
Copenhagen, n = 8 Leeds, n = 4 PsAMRIS Features Treatment Anti-TNF-α DMARD Assessment timepoints 0 and 12 months 0 and 12 months Field strength 0.6 T 0.2 T MRI sequences applied T1w pre-Gd injection x x Bone erosions, bone proliferation, n = 12 T1w post-Gd injection x Synovitis, tenosynovitis, periarticular inflammation, n = 8 STIR x Bone marrow edema, n = 8 -
TNF-α: tumor necrosis factor-α; DMARD: disease-modifying antirheumatic drugs; MRI: magnetic resonance imaging; T1w: t1 weighted MRI sequence; Gd: Gadolinium; STIR: short-tau inversion recovery.
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- Table 2.
Median (minimum, maximum) baseline and 1-year change in PsAMRIS features for overall scores and subjoint regions. All values are given as median (minimum to maximum) of the 4 scorers’ median scores.
PsAMRIS Features (range of total score) Baseline PsAMRIS One-year Change in PsAMRIS Total score MCP PIP DIP Total score MCP PIP DIP Synovitis (0–36) 11.3 (3.5 to 13) 3.0 (1.0 to 4.5) 4.0 (1.5 to .0) 0.75 (0.0 to 3.0) −1.5 (−11.0 to 3.5) −1.75 (−5.0 to 1.5) 0.0 (−6.0 to 3.0) −0.25 (−2.5 to 2.5) Flexor tenosynovitis (0–36) 5.3 (0.0 to 6.5) 1.25 (0.0 to 5.0) 0.0 (0.0 to 2.0) 0.0 (0.0 to 1.0) −2.0 (−9.0 to 1.5) −0.75 (−3.0 to 2.0) −1.0 (−3.5 to 0.0) 0.0 (−2.0 to 0.0) Periarticular inflammation (0–24) 0.3 (0.0 to 1.5) 0.0 (0.0 to 0.0) 0.0 (0.0 to 1.5) 0.0 (0.0 to 0.5) −0.25 (−4.0 to 0.0) 0.0 (−0.5 to 0.0) −0.25 (−3.5 to 0.0) 0.0 (−1.0 to 0.0) Bone marrow edema (0–72) 0.0 (0.0 to 1.5) 0.0 (0.0 to 1.0) 0.0 (0.0 to 0.5) 0.0 (0.0 to 0.0) 0.0 (−9.0 to 1.5) 0.0 (−1.5 to 1.0) 0.0 (−4.5 to 0.0) 0.0 (−2.5 to 0.0) Bone erosion (0–240) 2.0 (0.0 to 6.5) 1.5 (0.0 to 5.0) 0.0 (0.0 to 2.5) 0.0 (0.0 to 0.5) 0.0 (−0.5 to 1.0) 0.0 (0.0 to 1.0) 0.0 (−0.5 to 0.0) 0.0 (0.0 to 0.5) Bone proliferation (0–12) 3.0 (0.0 to 5.0) 0.0 (0.0 to 1.5) 0.0 (0.0 to 2.0) 0.75 (0.0 to 4.0) 0.0 (−0.5 to 0.5) 0.0 (0.0 to 0.0) 0.0 (0.0 to 0.0) 0.0 (0.0 to 0.0) -
PsAMRIS: psoriatic arthritis magnetic resonance imaging score; MCP: metacarpophalangeal joint; PIP: proximal interphalangeal joint; DIP: distal interphalangeal joint.
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- Table 3A.
Inter- and intrareader reliability for PsAMRIS status and change scores. Intraclass correlation coefficients. Key to SRM values: Very good, ICC ≥ 0.80; good, 0.50 ≤ ICC < 0.80; poor, 0.20 ≤ ICC < 0.50; trivial, ICC < 0.20.
Interreader Reliability, ICCa Intrareader Reliability, ICCs Reader 1 Reader 2 Reader 3 Reader 4 PsAMRIS Features Status Change Status Change Status Change Status Change Status Change Synovitis 0.95 0.95 0.97 0.78 0.73 0.63 0.93 0.65 0.90 0.38 Flexor tenosynovitis 0.97 0.95 0.81 0.92 0.74 0.73 0.93 0.80 0.73 0.90 Bone proliferation 0.77 0.10 0.20 0.26 0.84 0.87 0.79 0.73 0.44 0.46 Periarticular inflammation 0.91 0.91 0.39 NA* 0.95 NA* 0.88 0.33 0.91 NA* Bone marrow edema 0.87 0.87 0.98 0.63 0.97 0.13 0.99 1.00 0.03 0.80 Bone erosion 0.97 0.44 0.91 0.94 0.93 0.91 0.92 0.91 0.91 0.88 -
↵* Not calculable because zero variance. ICCa: average measure intraclass correlation coefficient; ICCs: single measure intraclass correlation coefficient; PsAMRIS: psoriatic arthritis magnetic resonance imaging score.
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- Table 3B.
Inter- and intrareader reliability for PsAMRIS status and change scores. Smallest detectable difference and change.
Interreader Reliability (SDD/SDC) Intrareader Reliability (SDD/SDC)* PsAMRIS Features Status Scores Change Scores Status Scores Change Scores SDD SDD%max SDD SDD%max SDD SDD%max SDD SDD%max Synovitis 2.78 13.89 3.19 13.28 3.54 27.62 4.71 32.17 Flexor tenosynovitis 3.35 27.91 2.97 19.79 4.71 45.27 4.08 42.10 Periarticular inflammation 2.11 35.18 2.43 26.98 2.17 33.79 2.02 30.65 Bone marrow edema 1.29 9.24 2.00 15.42 1.76 16.07 2.66 41.64 Bone erosion 1.38 19.66 0.84 21.05 1.79 24.44 1.29 42.99 Bone proliferation 2.62 32.71 0.57 18.94 2.74 57.68 0.92 70.08 -
↵* Median values of the 4 readers. SDD: smallest detectable differences; SDC: smallest detectable change; PsAMRIS: psoriatic arthritis magnetic resonance imaging score.
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- Table 4.
Sensitivity to change of the PsAMRIS measured by standardized response means (SRM). Key to SRM values: large, SRM ≥ 0.80; moderate, 0.50 ≤ SRM < 0.80; small, 0.20 ≤ SRM < 0.50; trivial, SRM < 0.20.
Standardized Response Mean PsAMRIS Features Total Score MCP Joints PIP Joints DIP Joints Synovitis −0.50 −0.77 −0.28 −022 Flexor tenosynovitis −0.79 −0.53 −0.97 −0.57 Periarticular inflammation −0.54 −0.47 −0.44 −0.72 Bone marrow edema −0.34 −0.08 −0.46 −0.31 Bone erosion 0.22 0.52 −0.53 0.00 Bone proliferation −0.11 −0.29 NA* 0.16 -
↵* Not calculated because zero variance. PsAMRIS: psoriatic arthritis magnetic resonance imaging score; MCP: metacarpophalangeal joint; PIP: proximal interphalangeal joint; DIP: distal interphalangeal joint.
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