Background: Plain radiography usual method to detect degeneration in the subtalar and talonavicluar joints. MRI is a better way to fully characterise non-ossified structures, such as articular cartilage, marrow tissue and synovial fluid and therefore detect changes of arthritis. The motivation behind this study was to develop a quantitative way to score arthritic changes to the subtalar and talonavicular joints using MRI. The developed system will then be used as a research tool and in the close assessment and monitoring of patients with hindfoot degenerative disease. Methods: The MRI scans of thirty consecutive subjects with foot and ankle pain were retrospectively evaluated. Images were interpreted independently by three musculoskeletal radiologists in order to determine intra-observer reliability as well as the inter-observer reliability of the score. Five features of osteoarthritis were scored in the Subtalar joint and the Talonavicular joint. These were cartilage morphology, subarticular marrow, subarticular cyst, marginal osteophytes and synovitis. Results: For the 30 MRI scans the mean score for the Subtalar joint ranged from 11.7 to 14.4 and for the Talonavicular joint ranged from 3.7 to 5.6. The inter-observer correlation for the Subtalar joint between the three readers ranged between 0.53 and 0.83 for the individual features but overall was excellent at 0.76. For the Talonavicular joint the total correlation was good at 0.67. The inter-observer ICC for the total score was 0.75 which showed excellent agreement between the three readers. The total intra-observer correlation was excellent. Conclusions: The current work has shown excellent reliability for the scoring system. It will be a useful tool to diagnose and monitor disease progression of the Subtalar and Talonavicluar joints.
References
[1]
Peterfy, C.G., Guermazi, A., Zaim, S., et al. (2004) Whole-Organ Magnetic Resonance Imaging Score (WORMS) of the Knee in Osteoarthritis. Osteoarthritis andCartilage, 12, 177-190. https://doi.org/10.1016/j.joca.2003.11.003
[2]
Lee, S., Nardo, L., Kumar, D., et al. (2015) Scoring Hip Osteoarthritis with MRI (SHOMRI): A Whole Joint Osteoarthritis Evaluation System. Journal of Magnetic Resonance Imaging, 41, 1549-1557. https://doi.org/10.1002/jmri.24722
[3]
Goldberg, A.J., Zaidi, R., Thomson, C., et al. (2016) Total Ankle Replacement versus Arthrodesis (TARVA): Protocol for a Multicentre Randomised Controlled Trial. BMJ Open, 6, e012716. https://doi.org/10.1136/bmjopen-2016-012716
[4]
Jorm, A.F. (2015) Using the Delphi Expert Consensus Method in Mental Health Research. Australian & New Zealand Journal of Psychiatry, 49, 887-897. https://doi.org/10.1177/0004867415600891
[5]
Barr, C., Bauer, J.S., Malfair, D., et al. (2007) MR Imaging of the Ankle at 3 Tesla and 1.5 Tesla: Protocol Optimization and Application to Cartilage, Ligament and Tendon Pathology in Cadaver Specimens. European Radiology, 17, 1518-1528. https://doi.org/10.1007/s00330-006-0446-4
[6]
Demehri, S., Hafezi-Nejad, N. and Carrino, J.A. (2015) Conventional and Novel Imaging Modalities in Osteoarthritis: Current State of the Evidence. Current Opinion in Rheumatology, 27, 295-303. https://doi.org/10.1097/BOR.0000000000000163
[7]
Guermazi, A., Niu, J., Hayashi, D., et al. (2012) Prevalence of Abnormalities in Knees Detected by MRI in Adults without Knee Osteoarthritis: Population Based Observational Study (Framingham Osteoarthritis Study). BMJ, 345, e5339-e5339. https://doi.org/10.1136/bmj.e5339
[8]
Wenham, C.Y.J., Grainger, A.J. and Conaghan, P.G. (2014) The Role of Imaging Modalities in the Diagnosis, Differential Diagnosis and Clinical Assessment of Peripheral Joint Osteoarthritis. Osteoarthritis Cartilage, 22, 1692-1702. https://doi.org/10.1016/j.joca.2014.06.005
[9]
Cicchetti, D.V. (1994) Guidelines, Criteria, and Rules of Thumb for Evaluating Normed and Standardized Assessment Instruments in Psychology.
[10]
Hunter, D.J., Lo, G.H., Gale, D., Grainger, A.J., Guermazi, A. and Conaghan, P.G. (2008) The Reliability of a New Scoring System for Knee Osteoarthritis MRI and the Validity of Bone Marrow Lesion Assessment: BLOKS (Boston Leeds Osteoarthritis Knee Score). Annals of the Rheumatic Diseases, 67, 206-211. https://doi.org/10.1136/ard.2006.066183
[11]
Kellgren, J.H. and Lawrence, J.S. (1957) Radiological Assessment of Osteo-Arthrosis. Annals of the Rheumatic Diseases, 16, 494-502. https://doi.org/10.1136/ard.16.4.494
[12]
Mayich, D.J., Pinsker, E., Mayich, M.S., Mak, W. and Daniels, T.R. (2013) An Analysis of the Use of the Kellgren and Lawrence Grading System to Evaluate Peritalar Arthritis Following Total Ankle Arthroplasty. Foot & Ankle International, 34, 1508-1515. https://doi.org/10.1177/1071100713495379
[13]
Holzer, N., Salvo, D., Marijnissen, A.C.A., et al. (2015) Radiographic Evaluation of Posttraumatic Osteoarthritis of the Ankle: The Kellgren-Lawrence Scale Is Reliable and Correlates with Clinical Symptoms. Osteoarthritis Cartilage, 23, 363-369. https://doi.org/10.1016/j.joca.2014.11.010
[14]
Bartoníček, J., Rammelt, S. and Naňka, O. (2018) Anatomy of the Subtalar Joint. Foot and Ankle Clinics, 23, 315-340. https://doi.org/10.1016/j.fcl.2018.04.001
