Development and Reliability of a Preliminary Foot Osteoarthritis Magnetic Resonance Imaging Score

Abstract

ObjectiveFoot osteoarthritis (OA) is very common but under-investigated musculoskeletal condition and there is little consensus as to common MRI imaging features. The aim of this study was to develop a preliminary foot OA MRI score (FOAMRIS) and evaluate its reliability. MethodsThis preliminary semi-quantitative score included the hindfoot, midfoot and metatarsophalangeal joints. Joints were scored for joint space narrowing (JSN, 0-3), osteophytes (0-3), joint effusion/synovitis and bone cysts (present/absent). Erosions and bone marrow lesions (BMLs) were scored (0-3) and BMLs were evaluated adjacent to entheses and at sub-tendon sites (present/absent). Additionally, tenosynovitis was scored (0-3) and midfoot ligament pathology was scored (present/absent). Reliability was evaluated in 15 people with foot pain and MRIdetected OA using 3.0T MRI multi-sequence protocols and assessed using ConclusionThis preliminary FOAMRIS demonstrated good intra-reader reliability and fair interreader reliability when assessing the total feature scores. Further development is required in cohorts with a range of pathologies and to assess the psychometric measurement properties.

Development and Reproducibility of a First Metatarsophalangeal Joint Osteoarthritis Magnetic Resonance Imaging Scoring System

“…Our atlas of first MTP joint OA was developed following a review of existing MRI atlases for OA at other joints (24)(25)(26)(27)(28)(29) and evaluates the presence and sever ity of osteophytes, bone marrow lesions, cysts, effusion synovitis, joint space narrowing, and cartilage loss. Recently, Halstead et al (19) presented a preliminary semi quantitative MRI scoring system for OA of the foot (FOAMRIS). Unlike the atlas presented in this study, the Halstead et al (19) scoring system did not include any assessment of the sesamoid com plex of the first MTP joint, direct assessment of cartilage loss (a key feature of OA), or pictorial representations for each MRI feature.…”

“…Recently, Halstead et al (19) presented a preliminary semi quantitative MRI scoring system for OA of the foot (FOAMRIS). Unlike the atlas presented in this study, the Halstead et al (19) scoring system did not include any assessment of the sesamoid com plex of the first MTP joint, direct assessment of cartilage loss (a key feature of OA), or pictorial representations for each MRI feature.…”

“…Halstead et al (19) also evaluated the reproducibility of their MRI scoring system using 15 participants with foot pain and MRI detected OA. For intraexaminer reproducibility, the findings reported by Halstead et al showed very close alignment with our study's findings.…”

“…MRI is a noninvasive multiplanar technique that allows for the assessment of all potentially relevant joint structures affected in OA (17,18). Recently, Halstead et al (19) developed a preliminary, semiquantitative MRI scoring system for OA of the foot (Foot Osteoarthritis Magnetic Resonance Imaging Score [FOAMRIS]). The scoring system examined multiple foot joints and included joint space narrowing, osteophytes, effusion/synovitis, bone marrow lesions, and soft tissue features (tenosynovitis).…”

A Pain in the Foot: Delayed Diagnosis of Primary Septic Arthritis of Naviculocuneiform and Second/Third Tarsometatarsal Joints

“…Although the first MRI showed degenerative changes in the midfoot, the patient denied having similar symptoms in the past and he was never diagnosed with OA. MRI features suggestive of OA typically include the presence of joint space narrowing, osteophytes, effusion/synovitis, bony erosions, and bone marrow lesions [ 26 ]. While there is no finding specific for OA, Halstead et al [ 26 ] proposed a scoring system using these MRI features to evaluate foot OA.…”