Assessment of osteoarthritic features in the thumb base with the newly developed OMERACT magnetic resonance imaging scoring system is a valid addition to standard radiography

Abstract

Objective: To investigate the construct validity of the new thumb base OA magnetic resonance imaging (MRI) scoring system (TOMS) by comparing TOMS scores with radiographic scores in patients with primary hand OA. Design: In 200 patients (83.5% women, mean (SD) age 61.0 (8.4) years), postero-anterior radiographs and MR scans (1.5 T) of the right first carpometacarpal (CMC-1) and scaphotrapeziotrapezoid (STT) joints, were scored using the OARSI atlas and TOMS, respectively. The distributions of the TOMS scores (specified in results section) were stratified for the OARSI scores of corresponding radiographic features and investigated using boxplots and non-parametric tests. Furthermore, Spearman's rank or Phi correlation coefficients (r/4) were calculated. Results: For all features, especially for erosions and osteophytes, the prevalence found with MRI was higher than with radiography. TOMS osteophyte and cartilage loss scores differed statistically significant between corresponding OARSI scores in CMC-1 (0 vs 1; 1 vs 2). TOMS scores were positively correlated with radiographic scores in CMC-1 for osteophytes (coefficient [95% confidence interval], r ¼ 0.75 [0.69; 0.81]), cartilage loss/joint space narrowing (r ¼ 0.70 [0.62; 0.76]), subchondral bone defects (SBDs)/ erosion-cyst (r ¼ 0.41 [0.29; 0.52]), bone marrow lesions (BMLs)/subchondral sclerosis (r ¼ 0.65 [0.56; 0.73]) and subluxation (4 ¼ 0.65 [0.57; 0.73]); and in STT for osteophytes (r ¼ 0.30 [0.17; 0.42]) and cartilage loss/joint space narrowing (r ¼ 0.53 [0.42; 0.62]). Conclusions: In patients with hand OA, TOMS scores positively correlated with radiographic scores, indicating good construct validity. However, the prevalence of features on MR images was higher compared to radiographs, suggesting that TOMS might be more sensitive than radiography. The clinical meaning of these extra MR detected cases is currently still unknown.

Two‐Year Changes in Magnetic Resonance Imaging Features and Pain in Thumb Base Osteoarthritis

“…In our study, increase in structural damage was more often seen on MRI than on radiography. The higher sensitivity of MRI to detect structural damage was also shown in a recent cross‐sectional study ( 27 ). Currently, structural damage assessed on radiographs is considered the gold standard.…”

Osteoarthritis year in review 2019: imaging

“…New semiquantitative scoring systems have recently been developed and validated for use in OA research studies to assess the severity of structural pathology in other joints. These include the Shoulder Osteoarthritis Severity Score (SOAS) for the shoulder joint 57 , Scoring Hip Osteoarthritis with Magnetic Resonance Imaging (SHOMRI) for the hip joint 58,59 , and Thumb Osteoarthritis MRI Score (TOMS) for the first carpometacarpal joint 60 . These new scoring systems have been shown to have high construct validity and high inter-observer agreement for assessing the severity of structural joint pathology on MRI.…”

Degenerative and inflammatory hand joint changes in osteoarthritis according to magnetic resonance imaging

“…[7] на основании рентгенологических исследований сообщают, что первое место по частоте занимает ОА суставов кистей (СК). Некоторые авторы считают, что наличие ОА СК указывает на генерализованный характер поражения [8,9]. Такие характерные рентгенологические симптомы ОА, как остеофиты (ОФ) и сужение суставных щелей (ССЩ), выявляются у 81% пациентов старше 60 лет [10].…”

“…Принимая во внимание данные W. Damman и соавт. [9] о большей частоте встречаемости ОКМ и синовитов у пациентов с рентгенологическим прогрессированием ОА в течение 2 лет проспективного наблюдения, более чем реальной представляется гипотеза о том, что ЭОА является наиболее тяжелым из условно принятых на сегодняшний день фенотипов ОА СК, однако для ее подтверждения требуются дальнейшие исследования и создание валидированной системы оценки изменений по данным МРТ.…”