Page 73 - Imaging of Osteoarthritis and Rheumatoid Arthritis in Hand Joints

1 0
2 6
3 0
4 2
5 22
6 0
7 4
8 25
9 10
10 1
11 3
12 16
Histology
loss loss
0 100
9 85
25 75
10 88
30 48
15 85
17 79
22 53
31 59
18 82
11 86
10 74
Normal Partial Full thickness thickness
Normal Partial Full Image thickness thickness Quality
loss loss
28 45 27 adequate 0 44 56 low
0 77 23 adequate 17 68 15 adequate 37 54 9 good
14 15 71 adequate
2 31 68 adequate 4 35 22 43 good
19 61 20 adequate
0 74 26 low
0 26 74 low
0 7 93 low
Accuracy of cartilage MRI of CMC1; comparison with histology
Table 1. Histological and MRI scoring results for each individual patient. For both methods the percentages of the articular surface are shown that were normal, had partial cartilage thickness loss, or had full cartilage thickness loss, as well as the MRI image quality.
Patient Histology MRI
The mean number of histological sections acquired from each trapezium containing articular surface was 10 (range 9-14). Ten patients were scored independently by both readers. The inter-reader reliability for the detection of any cartilage loss over all scored sections containing articular surface (n=100) was ICC=0.70 (95%CI= 0.53-0.81), and the inter-reader reliability over all sections for full cartilage loss was ICC=0.84 (95% CI= 0.76-0.90). Overall cartilage quality was poor (table 1). No patient had any normal healthy cartilage remaining. The best cartilage observed had a histological grade of 3, with vertical fissures into the mid zone and depletion of matrix staining in the upper half of the cartilage. In eleven out of twelve patients there was complete erosion of the cartilage on more than half of the articulating surface. The median (IQR) surface area of trapezial cartilage damage was 96% (87%-98%). The percentage area with full-thickness cartilage loss was 79% (67%-85%). After analysis, the largest differences between histological scores were in areas near osteophytes, which were sometimes partly covered with cartilage (fig2). For scoring purposes osteophytes were excluded from the articular surface, and the cartilage formed on top of osteophytes was ignored. The lack of a clear anatomical landmark
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