PT - JOURNAL ARTICLE AU - MIKKEL ØSTERGAARD AU - PERNILLE BØYESEN AU - IRIS ESHED AU - FRÉDÉRIQUE GANDJBAKHCH AU - SIRI LILLEGRAVEN AU - PAUL BIRD AU - VIOLAINE FOLTZ AU - ANNELIES BOONEN AU - MARISSA LASSERE AU - KAY-GEERT HERMANN AU - ALLEN ANANDARAJAH AU - UFFE MØLLER DØHN AU - JANE FREESTON AU - CHARLES G. PETERFY AU - HARRY K. GENANT AU - ESPEN A. HAAVARDSHOLM AU - FIONA M. McQUEEN AU - PHILIP G. CONAGHAN TI - Development and Preliminary Validation of a Magnetic Resonance Imaging Joint Space Narrowing Score for Use in Rheumatoid Arthritis: Potential Adjunct to the OMERACT RA MRI Scoring System AID - 10.3899/jrheum.110422 DP - 2011 Sep 01 TA - The Journal of Rheumatology PG - 2045--2050 VI - 38 IP - 9 4099 - http://www.jrheum.org/content/38/9/2045.short 4100 - http://www.jrheum.org/content/38/9/2045.full SO - J Rheumatol2011 Sep 01; 38 AB - Objective. To develop and validate a magnetic resonance imaging (MRI) method of assessment of joint space narrowing (JSN) in rheumatoid arthritis (RA). Methods. Phase A: JSN was scored 0–4 on MR images of 5 RA patients and 3 controls at 15 wrist sites and 2nd–5th metacarpophalangeal (MCP) joints by 8 readers (7 once, one twice), using a preliminary scoring system. Phase B: Image review, discussion, and consensus on JSN definition, and revised scoring system. Phase C: MR images of 15 RA patients and 4 controls were scored using revised system by 5 readers (4 once, one twice), and results compared with radiographs [Sharp-van der Heijde (SvdH) method]. Results. Phase A: Intraobserver agreement: intraclass correlation coefficient (ICC) = 0.99; smallest detectable difference (SDD, for mean of readings) = 2.8 JSN units (4.9% of observed maximal score). Interobserver agreement: ICC = 0.93; SDD = 6.4 JSN units (9.9%). Phase B: Agreement was reached on JSN definition (reduced joint space width compared to normal, as assessed in a slice perpendicular to the joint surface), and revised scoring system (0–4 at 17 wrist sites and 2nd–5th MCP; 0: none; 1: 1–33%; 2: 34–66%; 3: 67–99%; 4: ankylosis). Phase C: Intraobserver agreement: ICC = 0.90; SDD = 6.8 JSN units (11.0%). Interobserver agreement: ICC = 0.92 and SDD = 6.2 JSN units (8.7%). The correlation (ICC) with the SvdH radiographic JSN score of the wrist/hand was 0.77. Simplified approaches evaluating fewer joint spaces demonstrated similar reliability and correlation with radiographic scores. Conclusion. An MRI scoring system of JSN in RA wrist and MCP joints was developed and showed construct validity and good intra- and interreader agreements. The system may, after further validation in longitudinal data sets, be useful as an outcome measure in RA.