title: Magnetic Resonance Imaging in Hand Osteoarthritis: Intraobserver Reliability and Criterion Validity for Clinical and Structural Characteristics.
abstract: OBJECTIVE
  To investigate criterion validity and intraobserver reliability of magnetic resonance imaging (MRI) in hand osteoarthritis (HOA).
  
  
  METHODS
  In 16 patients with HOA (median age 57 yrs, 62% women, 13 with erosive OA), 3 Tesla MRI scans with gadolinium-chelate administration of right second to fifth distal interphalangeal/proximal interphalangeal joints were scored according to the Oslo HOA scoring method for synovial thickening, bone marrow lesions (BML), osteophytes, joint space narrowing (JSN), and erosions (grade 0-3). Ultrasound (US) was scored for synovial thickening and osteophytes, radiographs for osteophytes and JSN (Osteoarthritis Research Society International score), and anatomical phases (Verbruggen-Veys score). Pain was assessed during physical examination. Correlations of MRI with US and radiographic features were assessed with generalizability theory. With generalized estimating equations analyses, MRI features were associated with pain, adjusting for confounding.
  
  
  RESULTS
  Forty-three percent, 27%, 77%, and 61% of joints had synovial thickening (moderate/severe), BML, osteophytes, and erosions on MRI, respectively. Intraobserver reliability, assessed in 6 patients, was good (ICC 0.77-1.00). Correlations between osteophytes, JSN, and erosions on radiographs and MRI were moderate, substantial, and fair (ICC 0.53, 0.68, and 0.32, respectively); MRI showed more lesions than radiography. Correlation between synovial thickening and osteophytes on MRI and US was moderate (ICC 0.43 and 0.49, respectively). MRI was more sensitive for synovial thickening, US for osteophytes. Pain was associated with moderate/severe synovial thickening (adjusted OR 2.4, 95% CI 1.06-5.5), collateral ligaments (4.2, 2.2-8.3), BML (3.5, 1.6-7.7), erosions (4.5, 1.7-12.2), and osteophytes (2.4, 1.1-5.2).
  
  
  CONCLUSIONS
  MRI is a reliable and valid method to assess inflammatory and structural features in HOA. It gives additional information over radiographs and US.
authors.affiliation: From the Department of Rheumatology, Department of Radiology, and Department of Medical Statistics, Leiden University Medical Centre, Leiden, the Netherlands; Department of Rheumatology Diakonhjemmet Hospital, Oslo, Norway.M.C. Kortekaas, MD; W.Y. Kwok, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; M. Reijnierse, MD, PhD, Department of Radiology, Leiden University Medical Center; R. Wolterbeek, PhD, Department of Medical Statistics, Leiden University Medical Center; P. Bøyesen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; D. van der Heijde, MD, PhD, Department of Rheumatology, Leiden University Medical Centre, and Department of Rheumatology, Diakonhjemmet Hospital; J.L. Bloem, MD, PhD, Department of Radiology, Leiden University Medical Center; M. Kloppenburg, MD, PhD, Department of Rheumatology, Leiden University Medical Centre. m.c.kortekaas@lumc.nl.
authors.forename: Marion C
authors.initials: MC
authors.lastname: Kortekaas
authors.affiliation: From the Department of Rheumatology, Department of Radiology, and Department of Medical Statistics, Leiden University Medical Centre, Leiden, the Netherlands; Department of Rheumatology Diakonhjemmet Hospital, Oslo, Norway.M.C. Kortekaas, MD; W.Y. Kwok, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; M. Reijnierse, MD, PhD, Department of Radiology, Leiden University Medical Center; R. Wolterbeek, PhD, Department of Medical Statistics, Leiden University Medical Center; P. Bøyesen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; D. van der Heijde, MD, PhD, Department of Rheumatology, Leiden University Medical Centre, and Department of Rheumatology, Diakonhjemmet Hospital; J.L. Bloem, MD, PhD, Department of Radiology, Leiden University Medical Center; M. Kloppenburg, MD, PhD, Department of Rheumatology, Leiden University Medical Centre.
authors.forename: Wing-Yee
authors.initials: WY
authors.lastname: Kwok
authors.affiliation: From the Department of Rheumatology, Department of Radiology, and Department of Medical Statistics, Leiden University Medical Centre, Leiden, the Netherlands; Department of Rheumatology Diakonhjemmet Hospital, Oslo, Norway.M.C. Kortekaas, MD; W.Y. Kwok, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; M. Reijnierse, MD, PhD, Department of Radiology, Leiden University Medical Center; R. Wolterbeek, PhD, Department of Medical Statistics, Leiden University Medical Center; P. Bøyesen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; D. van der Heijde, MD, PhD, Department of Rheumatology, Leiden University Medical Centre, and Department of Rheumatology, Diakonhjemmet Hospital; J.L. Bloem, MD, PhD, Department of Radiology, Leiden University Medical Center; M. Kloppenburg, MD, PhD, Department of Rheumatology, Leiden University Medical Centre.
authors.forename: Monique
authors.initials: M
authors.lastname: Reijnierse
authors.affiliation: From the Department of Rheumatology, Department of Radiology, and Department of Medical Statistics, Leiden University Medical Centre, Leiden, the Netherlands; Department of Rheumatology Diakonhjemmet Hospital, Oslo, Norway.M.C. Kortekaas, MD; W.Y. Kwok, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; M. Reijnierse, MD, PhD, Department of Radiology, Leiden University Medical Center; R. Wolterbeek, PhD, Department of Medical Statistics, Leiden University Medical Center; P. Bøyesen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; D. van der Heijde, MD, PhD, Department of Rheumatology, Leiden University Medical Centre, and Department of Rheumatology, Diakonhjemmet Hospital; J.L. Bloem, MD, PhD, Department of Radiology, Leiden University Medical Center; M. Kloppenburg, MD, PhD, Department of Rheumatology, Leiden University Medical Centre.
authors.forename: Ron
authors.initials: R
authors.lastname: Wolterbeek
authors.affiliation: From the Department of Rheumatology, Department of Radiology, and Department of Medical Statistics, Leiden University Medical Centre, Leiden, the Netherlands; Department of Rheumatology Diakonhjemmet Hospital, Oslo, Norway.M.C. Kortekaas, MD; W.Y. Kwok, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; M. Reijnierse, MD, PhD, Department of Radiology, Leiden University Medical Center; R. Wolterbeek, PhD, Department of Medical Statistics, Leiden University Medical Center; P. Bøyesen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; D. van der Heijde, MD, PhD, Department of Rheumatology, Leiden University Medical Centre, and Department of Rheumatology, Diakonhjemmet Hospital; J.L. Bloem, MD, PhD, Department of Radiology, Leiden University Medical Center; M. Kloppenburg, MD, PhD, Department of Rheumatology, Leiden University Medical Centre.
authors.forename: Pernille
authors.initials: P
authors.lastname: Bøyesen
authors.affiliation: From the Department of Rheumatology, Department of Radiology, and Department of Medical Statistics, Leiden University Medical Centre, Leiden, the Netherlands; Department of Rheumatology Diakonhjemmet Hospital, Oslo, Norway.M.C. Kortekaas, MD; W.Y. Kwok, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; M. Reijnierse, MD, PhD, Department of Radiology, Leiden University Medical Center; R. Wolterbeek, PhD, Department of Medical Statistics, Leiden University Medical Center; P. Bøyesen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; D. van der Heijde, MD, PhD, Department of Rheumatology, Leiden University Medical Centre, and Department of Rheumatology, Diakonhjemmet Hospital; J.L. Bloem, MD, PhD, Department of Radiology, Leiden University Medical Center; M. Kloppenburg, MD, PhD, Department of Rheumatology, Leiden University Medical Centre.
authors.forename: Desiree
authors.initials: D
authors.lastname: van der Heijde
authors.affiliation: From the Department of Rheumatology, Department of Radiology, and Department of Medical Statistics, Leiden University Medical Centre, Leiden, the Netherlands; Department of Rheumatology Diakonhjemmet Hospital, Oslo, Norway.M.C. Kortekaas, MD; W.Y. Kwok, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; M. Reijnierse, MD, PhD, Department of Radiology, Leiden University Medical Center; R. Wolterbeek, PhD, Department of Medical Statistics, Leiden University Medical Center; P. Bøyesen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; D. van der Heijde, MD, PhD, Department of Rheumatology, Leiden University Medical Centre, and Department of Rheumatology, Diakonhjemmet Hospital; J.L. Bloem, MD, PhD, Department of Radiology, Leiden University Medical Center; M. Kloppenburg, MD, PhD, Department of Rheumatology, Leiden University Medical Centre.
authors.forename: Johannes L
authors.initials: JL
authors.lastname: Bloem
authors.affiliation: From the Department of Rheumatology, Department of Radiology, and Department of Medical Statistics, Leiden University Medical Centre, Leiden, the Netherlands; Department of Rheumatology Diakonhjemmet Hospital, Oslo, Norway.M.C. Kortekaas, MD; W.Y. Kwok, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; M. Reijnierse, MD, PhD, Department of Radiology, Leiden University Medical Center; R. Wolterbeek, PhD, Department of Medical Statistics, Leiden University Medical Center; P. Bøyesen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; D. van der Heijde, MD, PhD, Department of Rheumatology, Leiden University Medical Centre, and Department of Rheumatology, Diakonhjemmet Hospital; J.L. Bloem, MD, PhD, Department of Radiology, Leiden University Medical Center; M. Kloppenburg, MD, PhD, Department of Rheumatology, Leiden University Medical Centre.
authors.forename: Margreet
authors.initials: M
authors.lastname: Kloppenburg
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D050823:Hand Joints / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000473:pathology*; D054850:Osteophyte / Q000000981:diagnostic imaging / Q000473:pathology*; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013583:Synovial Membrane / Q000000981:diagnostic imaging / Q000473:pathology*; D013585:Synovitis / Q000000981:diagnostic imaging / Q000473:pathology*; D014463:Ultrasonography
keywords: INFLAMMATION; MRI; OSTEOARTHRITIS; ULTRASONOGRAPHY; VALIDITY