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Development and Reproducibility of a First Metatarsophalangeal Joint Osteoarthritis Magnetic Resonance Imaging Scoring System
Author(s) -
Munteanu Shan E.,
Auhl Maria,
Tan Jade M.,
Landorf Karl B.,
Elzarka Ayman,
Tan Beng,
Menz Hylton B.
Publication year - 2020
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.24016
Subject(s) - osteoarthritis , reproducibility , phalanx , medicine , magnetic resonance imaging , first metatarsal , atlas (anatomy) , metacarpal bones , synovitis , joint (building) , orthodontics , anatomy , nuclear medicine , radiology , pathology , arthritis , osteotomy , statistics , alternative medicine , mathematics , architectural engineering , engineering
Objective To develop a magnetic resonance imaging ( MRI ) atlas for the assessment of osteoarthritis ( OA ) of the first metatarsophalangeal ( MTP ) joint, and to assess its intra‐ and interexaminer reproducibility. Methods MRI (proton density with and without fat suppression) was performed on the first MTP joint of 60 participants (30 participants with first MTP joint OA and 30 participants without first MTP joint OA ). Characteristic MRI features of OA were then used to develop an MRI atlas of first MTP joint OA . The atlas assessed osteophytes (dorsal metatarsal head, plantar metatarsal head, dorsal proximal phalanx), bone marrow lesions (metatarsal head, proximal phalanx, sesamoids), cysts (metatarsal head, proximal phalanx), effusion‐synovitis (dorsal, plantar), joint space narrowing (metatarsal‐proximal phalanx, metatarsal sesamoids), and cartilage loss. To assess the reproducibility of the atlas, 2 examiners independently rated the MRI s of 30 participants on 2 occasions. Intra‐ and interexaminer reproducibility were determined using percentage agreement and Gwet's AC 1. Results Observations using the atlas demonstrated fair‐to‐perfect intraexaminer reproducibility (percentage agreement from 67% to 100%, and Gwet's AC 1 from 0.38 to 1.00) and fair‐to‐almost‐perfect interexaminer reproducibility (percentage agreement from 67% to 98%, and Gwet's AC 1 from 0.40 to 0.96). Conclusion An MRI scoring system for the assessment of OA of the first MTP joint has been developed. The atlas demonstrates excellent intra‐ and interexaminer reproducibility. The atlas has the potential to allow for a better understanding of the cause(s) of pain in first MTP joint OA .