Page 37 - Imaging of Osteoarthritis and Rheumatoid Arthritis in Hand Joints

Systematic review of advanced hand OA imaging
amean thickness in mm; b median instead of mean; Se = Sensitivity; Sp = Specificity; PD = Power Doppler; JSN = Joint Space Narrowing; CR = Conventional Radiography; OR = Odds Ratio; CI = Confidence Interval VAS = Visual Analogue Score; HOA= patients with hand osteoarthritis; HC = Healthy Controls. ccompared with Kellgren and Lawrence score>2
dCR scoring not according to previous known system
eCR definitions according to Altman atlas 2004
fCR definitions according to Verbruggen scoring system
gCR definitions according to Altman atlas 1995 2 hCR definitions according to Altman atlas 2007
i CR scored according to Altman atlas , if any feature was detected, the joint was scored as positive kmean score on the Kallman scale, (maximum of 300 per patient);
jmean score instead of affected joints, score range per joint was 0-3
Reliability
Eight US, four MRI and two scintigraphy studies examined reliability (table 3). Four US studies assessed inter-reader reliability. In two studies agreement was good (κ=0.83-0.99) for synovitis, PD, effusion, osteophytes and erosions,52, 53 while in one study this varied for synovitis, PD and osteophytes (κ=0.229- 0.530).40 Intra-reader reliability was assessed in five studies. In four studies, intra-reader reliability assessed by one reader was moderate to good (κ=0.62- 0.94) for synovitis, PD, JSN, effusion and osteophytes, and good for cartilage thickness (ICC=0.96).42, 46, 51, 60 The fifth study reported intra-reader reliability for seven readers, ranging from poor to good (κ=0.172-1.0) for synovitis, PD, and osteophytes.40
Three MRI studies reported that inter-reader reliability was high for erosions, JSN, BML, malalignment and ligament absence (κ=0.76-0.84 and ICC=0.79- 0.97); moderate to good for synovitis and tenosynovitis (κ=0.58 and ICC=0.48- 0.51); low for cysts (ICC=0.21); and variable for osteophytes (κ=0.15 and ICC=0.88).33, 34, 53 MRI Intra-reader reliability was assessed in two studies and was high for synovitis, osteophytes, erosions, JSN, BML, malalignment and ligaments (κ=0.71-0.84 and ICC=0.84-0.99); moderate for cysts (κ=0.66 and ICC=0.59); and variable for tenosynovitis (κ=0.30 and ICC=0.63).34, 35
One scintigraphy study reported high inter-reader reliability (κ=0.61-0.82),49 and one scintigraphy study reported high intra-reader reliability (κ=0.84).39
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