title: Magnetic resonance imaging of the rheumatic foot according to the RAMRIS system is reliable.
abstract: OBJECTIVE
  In rheumatology, magnetic resonance imaging (MRI) is predominantly applied in the assessment and outcome measurement of rheumatoid arthritis (RA) in hands and wrists, leading to the development of the RAMRIS (RA-MRI-Scoring) system. It was initiated by the Outcome Measures in Rheumatoid Arthritis Clinical Trials (OMERACT). The RAMRIS system has not been applied widely in the measurement of feet. We investigated the interreader and intrareader agreement of the RAMRIS scoring system in the assessment of feet in RA.
  
  
  METHODS
  Twenty-nine patients with RA who had radiological damage and/or arthritis underwent MRI. Two experienced readers independently read both complete sets. One reader read 6 random sets after the initial session, in order to assess the intrareader agreement. For evaluation of the intrareader and interreader reliability, quadratic-weighted κ scores were calculated per joint and lesion.
  
  
  RESULTS
  For the forefeet, interreader scores were excellent, ranging from 0.77 (bone edema) to 0.95 (bone erosion). Hindfoot interreader agreement scores were highest for erosion (0.90) and synovitis global score (0.88), but edema and synovial thickness agreement were also acceptable (0.83 and 0.86). Intrareader scores were on the whole slightly lower, but excellent.
  
  
  CONCLUSIONS
  Reliability (interreader and intrareader agreement) in the assessment of the rheumatoid foot according to the RAMRIS method is excellent.
authors.affiliation: Department of Rheumatology, ZGT, Locatie Twenteborg Ziekenhuis, Postbus 7600, 7600 SZ Almelo, The Netherlands. h.baan@zgt.nl
authors.forename: Henriëtte
authors.initials: H
authors.lastname: Baan
authors.forename: Roland
authors.initials: R
authors.lastname: Bezooijen
authors.forename: Johannes K A
authors.initials: JK
authors.lastname: Avenarius
authors.forename: Rosemary
authors.initials: R
authors.lastname: Dubbeldam
authors.forename: Wiepke K
authors.initials: WK
authors.lastname: Drossaers-Bakker
authors.forename: Martin A F J
authors.initials: MA
authors.lastname: van de Laar
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000473:pathology*; D005260:Female; D033023:Foot Joints / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015203:Reproducibility of Results; D012720:Severity of Illness Index