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Sande NK, Kirkhus E, Lilleby V, Tomterstad AH, Aga AB, Flatø B, Bøyesen P. Validity of an ultrasonographic joint-specific scoring system in juvenile idiopathic arthritis: a cross-sectional study comparing ultrasound findings of synovitis with whole-body magnetic resonance imaging and clinical assessment. RMD Open 2024; 10:e003965. [PMID: 38428979 PMCID: PMC10910647 DOI: 10.1136/rmdopen-2023-003965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 02/12/2024] [Indexed: 03/03/2024] Open
Abstract
OBJECTIVE To assess the validity of an ultrasonographic scoring system in juvenile idiopathic arthritis (JIA) by comparing ultrasound detected synovitis with whole-body MRI and clinical assessment of disease activity. METHODS In a cross-sectional study, 27 patients with active JIA underwent clinical 71-joints examination, non-contrast enhanced whole-body MRI and ultrasound evaluation of 28 joints (elbow, radiocarpal, midcarpal, metacarpophalangeal 2-3, proximal interphalangeal 2-3, hip, knee, tibiotalar, talonavicular, subtalar and metatarsophalangeal 2-3). One rheumatologist, blinded to clinical findings, performed ultrasound and scored synovitis (B-mode and power Doppler) findings using a semiquantitative joint-specific scoring system for synovitis in JIA. A radiologist scored effusion/synovial thickening on whole-body MRI using a scoring system for whole-body MRI in JIA. At patient level, associations between ultrasound synovitis sum scores, whole-body MRI effusion/synovial thickening sum scores, clinical arthritis sum scores, and the 71-joints Juvenile Arthritis Disease Activity Score (JADAS71) were calculated using Spearman's correlation coefficients (rs). To explore associations at joint level, sensitivity and specificity were calculated for ultrasound using whole-body MRI or clinical joint examination as reference. RESULTS Ultrasound synovitis sum scores strongly correlated with whole-body MRI effusion/synovial thickening sum scores (rs=0.74,p<0.01) and the JADAS71 (rs=0.71,p<0.01), and moderately with clinical arthritis sum scores (rs=0.57,p<0.01). Sensitivity/specificity of ultrasound in detecting synovitis were 0.57/0.96 and 0.55/0.96 using whole-body MRI or clinical joint examination as reference, respectively. CONCLUSION Our findings suggest that ultrasound is a valid instrument to detect synovitis, and that ultrasound synovitis sum scores can reflect disease activity and may be an outcome measure in JIA.
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Affiliation(s)
- Nina Krafft Sande
- Department of Rheumatology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Eva Kirkhus
- Department of Radiology, Oslo University Hospital, Oslo, Norway
| | - Vibke Lilleby
- Department of Rheumatology, Oslo University Hospital, Oslo, Norway
| | | | | | - Berit Flatø
- Department of Rheumatology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Pernille Bøyesen
- Department of Rheumatology, Oslo University Hospital, Oslo, Norway
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2
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Østergaard M, van Vollenhoven RF, Rudin A, Hetland ML, Heiberg MS, Nordström DC, Nurmohamed MT, Gudbjornsson B, Ørnbjerg LM, Bøyesen P, Lend K, Hørslev-Petersen K, Uhlig T, Sokka T, Grondal G, Krabbe S, Lindqvist J, Gjertsson I, Glinatsi D, Kapetanovic MC, Aga AB, Faustini F, Parmanne P, Lorenzen T, Giovanni C, Back J, Hendricks O, Vedder D, Rannio T, Grenholm E, Ljoså MK, Brodin E, Lindegaard H, Söderbergh A, Rizk M, Kastbom A, Larsson P, Uhrenholt L, Just SA, Stevens DJ, Bay Laurbjerg T, Bakland G, Olsen IC, Haavardsholm EA, Lampa J. Certolizumab pegol, abatacept, tocilizumab or active conventional treatment in early rheumatoid arthritis: 48-week clinical and radiographic results of the investigator-initiated randomised controlled NORD-STAR trial. Ann Rheum Dis 2023; 82:1286-1295. [PMID: 37423647 DOI: 10.1136/ard-2023-224116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 06/07/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND The optimal first-line treatment in early rheumatoid arthritis (RA) is debated. We compared clinical and radiographic outcomes of active conventional therapy with each of three biological treatments with different modes of action. METHODS Investigator-initiated, randomised, blinded-assessor study. Patients with treatment-naïve early RA with moderate-severe disease activity were randomised 1:1:1:1 to methotrexate combined with (1) active conventional therapy: oral prednisolone (tapered quickly, discontinued at week 36) or sulfasalazine, hydroxychloroquine and intra-articular glucocorticoid injections in swollen joints; (2) certolizumab pegol; (3) abatacept or (4) tocilizumab. Coprimary endpoints were week 48 Clinical Disease Activity Index (CDAI) remission (CDAI ≤2.8) and change in radiographic van der Heijde-modified Sharp Score, estimated using logistic regression and analysis of covariance, adjusted for sex, anticitrullinated protein antibody status and country. Bonferroni's and Dunnet's procedures adjusted for multiple testing (significance level: 0.025). RESULTS Eight hundred and twelve patients were randomised. Adjusted CDAI remission rates at week 48 were: 59.3% (abatacept), 52.3% (certolizumab), 51.9% (tocilizumab) and 39.2% (active conventional therapy). Compared with active conventional therapy, CDAI remission rates were significantly higher for abatacept (adjusted difference +20.1%, p<0.001) and certolizumab (+13.1%, p=0.021), but not for tocilizumab (+12.7%, p=0.030). Key secondary clinical outcomes were consistently better in biological groups. Radiographic progression was low, without group differences.The proportions of patients with serious adverse events were abatacept, 8.3%; certolizumab, 12.4%; tocilizumab, 9.2%; and active conventional therapy, 10.7%. CONCLUSIONS Compared with active conventional therapy, clinical remission rates were superior for abatacept and certolizumab pegol, but not for tocilizumab. Radiographic progression was low and similar between treatments. TRIAL REGISTRATION NUMBER NCT01491815.
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Affiliation(s)
- Mikkel Østergaard
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet, Glostrup, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Ronald F van Vollenhoven
- Department of Rheumatology and Clinical Immunology, Amsterdam University Medical Center, Amsterdam Rheumatology and Immunology Center, Amsterdam, Netherlands
| | - Anna Rudin
- Department of Rheumatology and Inflammation Research, Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Rheumatology Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Merete Lund Hetland
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet, Glostrup, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Marte Schrumpf Heiberg
- Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
| | - Dan C Nordström
- Division of Internal Medicine and Rheumatology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Michael T Nurmohamed
- Location VUmc, Reade and Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Bjorn Gudbjornsson
- Landspitali University Hospital, University of Iceland, Reykjavik, Iceland
- Department of Rheumatology, Centre for Rheumatology Research, Reykjavik, Iceland
| | - Lykke Midtbøll Ørnbjerg
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet, Glostrup, Copenhagen, Denmark
| | - Pernille Bøyesen
- Department of Rheumatology, Oslo University Hospital, Oslo, Norway
| | - Kristina Lend
- Department of Rheumatology and Clinical Immunology, Amsterdam University Medical Center, Amsterdam Rheumatology Center, Amsterdam, Netherlands
- Department of Medicine, Rheumatology Unit, Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden
| | - Kim Hørslev-Petersen
- Department of Rheumatology, Danish Hospital for Rheumatic Diseases, Sønderborg, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Till Uhlig
- Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
| | - Tuulikki Sokka
- Jyväskylä Central Hospital, University of Eastern Finland, Jyväskylä, Finland
| | - Gerdur Grondal
- Landspitali University Hospital, University of Iceland, Reykjavik, Iceland
| | - Simon Krabbe
- Department of Radiology, Herlev-Gentofte University Hospital, Herlev, Denmark
| | - Joakim Lindqvist
- Department of Medicine, Rheumatology Unit, Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden
- Department of Gastroenterology, Dermatology and Rheumatology, Karolinska University Hospital, Stockholm, Sweden
| | - Inger Gjertsson
- Rheumatology Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Rheumatology and Inflammation Research, University of Gothenburg Sahlgrenska Academy, Gothenburg, Sweden
| | - Daniel Glinatsi
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Rigshospitalet, Rigshospitalet, Glostrup, Denmark
- Department of Rheumatology, Skaraborg Hospital, Skövde, Sweden
| | | | | | - Francesca Faustini
- Department of Medicine, Rheumatology Unit, Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden
| | - Pinja Parmanne
- Division of Internal Medicine and Rheumatology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Tove Lorenzen
- Department of Rheumatology, Silkeborg University Hospital, Silkeborg, Denmark
| | - Cagnotto Giovanni
- Department of Clinical Sciences, Lund University, Lund, Sweden
- Department of Rheumatology, Skåne University Hospital, Lund, Sweden
| | - Johan Back
- Department of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden
| | - Oliver Hendricks
- Department of Rheumatology, Danish Hospital for Rheumatic Diseases, Sønderborg, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Daisy Vedder
- Department of Rheumatology, Reade, Amsterdam, Netherlands
| | - Tuomas Rannio
- Jyväskylä Central Hospital, University of Eastern Finland, Jyväskylä, Finland
| | | | | | - Eli Brodin
- Department of Rheumatology, Haukeland University Hospital, Bergen, Norway
| | - Hanne Lindegaard
- Rheumatology Research Unit, Odense University Hospital, Odense, Denmark
| | - Annika Söderbergh
- Department of Rheumatology, Örebro University Hospital, Orebro, Sweden
| | - Milad Rizk
- Department of Rheumatology, Västmanlands Hospital Västerås, Västerås, Sweden
| | - Alf Kastbom
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Rheumatology in Östergötland, Linköping, Sweden
| | - Per Larsson
- Academic Specialist Center, Stockholm, Sweden
| | - Line Uhrenholt
- Department of Rheumatology, Aalborg University Hospital, Aalborg, Denmark
| | - Søren Andreas Just
- Department of Rheumatology, Odense Universitetshospital, Odense, Denmark
- Section of Rheumatology, Department of Medicine, Svendborg Hospital, Svendborg, Denmark
| | - David J Stevens
- Department of Rheumatology, St. Olavs Hospital, University Hospital of Trondheim, Trondheim, Norway
| | | | - Gunnstein Bakland
- Department of Rheumatology, University Hospital of Northern Norway, Tromsø, Norway
- Department Rheumatology, University of Tromsø, Tromsø, Norway
| | - Inge Christoffer Olsen
- Department of Research Support for Clinical Trials, Oslo University Hospital, Oslo, Norway
| | - Espen A Haavardsholm
- Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
| | - Jon Lampa
- Department of Medicine, Rheumatology Unit, Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden
- Department of Gastroenterology, Dermatology and Rheumatology, Karolinska University Hospital, Stockholm, Sweden
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Sande NK, Lilleby V, Aga AB, Kirkhus E, Flatø B, Bøyesen P. Associations between power Doppler ultrasound findings and B-mode synovitis and clinical arthritis in juvenile idiopathic arthritis using a standardised scanning approach and scoring system. RMD Open 2023; 9:rmdopen-2022-002937. [PMID: 36963783 PMCID: PMC10040011 DOI: 10.1136/rmdopen-2022-002937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 03/02/2023] [Indexed: 03/26/2023] Open
Abstract
OBJECTIVES To describe power Doppler (PD) ultrasound findings in joint regions with B-mode (BM) synovitis using a standardised scanning protocol and scoring system in patients with juvenile idiopathic arthritis (JIA). Further, to examine associations between PD findings and BM synovitis, clinical arthritis, patient characteristics and disease activity. METHODS In this cross-sectional study, one experienced ultrasonographer, blinded to clinical findings, performed ultrasound examinations in 27 JIA patients with suspected clinical arthritis. The elbow, wrist, metacarpophalangeal 2-3, proximal interphalangeal 2-3, knee, ankle and metatarsophalangeal 2-3 joints were assessed bilaterally and scored semiquantitatively (grades 0-3) for BM and PD findings using a joint-specific scoring system with reference atlas. Multilevel mixed-effects ordered regression models were used to explore associations between PD findings and BM synovitis, clinical arthritis, age, sex, JIA subgroups, disease duration and 10-joint Juvenile Arthritis Disease Activity Score (JADAS10). RESULTS Twenty-one girls and six boys, median age (IQR) 8 years (6-12 years) were included. Overall, 971 joint regions were evaluated by ultrasound, 129 had BM synovitis and were assessed for PD. PD findings were detected in 45 joint regions (34.9%), most frequently in the parapatellar recess of the knee (24.4%). Increasing PD grades were associated with higher BM grades (OR=5.0,p<0.001) and with clinical arthritis (OR=7.4,p<0.001) but not with age, sex, JIA subgroups, disease duration or JADAS10. CONCLUSION Increasing severity of PD findings were significantly associated with BM synovitis and with clinical arthritis. This suggests that PD signals detected using a standardised ultrasound examination and scoring system can reflect active disease in JIA patients.
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Affiliation(s)
- Nina Krafft Sande
- Department of Rheumatology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Vibke Lilleby
- Department of Rheumatology, Oslo University Hospital, Oslo, Norway
| | | | - Eva Kirkhus
- Department of Radiology, Oslo University Hospital, Oslo, Norway
| | - Berit Flatø
- Department of Rheumatology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Pernille Bøyesen
- Department of Rheumatology, Oslo University Hospital, Oslo, Norway
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4
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Sande NK, Bøyesen P, Aga AB, Hammer HB, Flatø B, Roth J, Lilleby V. Development and reliability of a novel ultrasonographic joint-specific scoring system for synovitis with reference atlas for patients with juvenile idiopathic arthritis. RMD Open 2021; 7:rmdopen-2021-001581. [PMID: 33883255 PMCID: PMC8061832 DOI: 10.1136/rmdopen-2021-001581] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 03/03/2021] [Accepted: 04/02/2021] [Indexed: 11/09/2022] Open
Abstract
Objective To develop an ultrasonographic image acquisition protocol and a joint-specific scoring system for synovitis with reference atlas in patients with juvenile idiopathic arthritis (JIA) and to assess the reliability of the system. Methods Seven rheumatologists with extensive ultrasound experience developed a scanning protocol and a semiquantitative joint-specific scoring system for B-mode (BM) synovitis for the elbow, wrist, metacarpophalangeal 2–3, proximal interphalangeal 2–3, hip, knee, ankle and metatarsophalangeal 2–3 joints. An ultrasonographic reference atlas for BM synovitis, divided in four age groups (2–4, 5–8, 9–12, 13–18 years), and power Doppler (PD) activity was then developed. Reliability was assessed for all joints on still images and in a live exercise including 10 patients with JIA, calculated by intraclass correlation coefficient (ICC) and weighted kappa. Results A scanning protocol and scoring system for multiple joints with reference atlas composed of images with four different score levels for BM and PD were developed. Still image scoring for BM synovitis on joint level showed good to excellent intra-reader reliability (ICC/kappa ranges: 0.75–0.95/0.63–0.91) and moderate to excellent inter-reader reliability (ICC/kappa ranges: 0.89–0.99/0.50–0.91). Still image scoring for PD activity showed excellent intra-reader and inter-reader reliability (ICC/kappa: 0.96/0.91 and ICC/kappa: 0.97/0.80, respectively). In the live scoring, inter-reader reliability (ICC/kappa) was moderate to excellent for BM synovitis (0.94/0.51) and PD activity (0.91/0.60). Conclusion An ultrasonographic image acquisition protocol and joint-specific scoring system with reference atlas were developed and demonstrated moderate to excellent reliability for scoring of synovitis in patients with JIA. This can be a valuable tool in clinical practice and future research.
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Affiliation(s)
| | - Pernille Bøyesen
- Department of Rheumatology, Oslo University Hospital, Oslo, Norway
| | | | - Hilde Berner Hammer
- Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Berit Flatø
- Department of Rheumatology, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Johannes Roth
- Division of Pediatric Dermatology and Rheumatology, Children's Hospital of Eastern Ontario and University of Ottawa, Ottawa, Ontario, Canada
| | - Vibke Lilleby
- Department of Rheumatology, Oslo University Hospital, Oslo, Norway
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5
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Felbo SK, Wiell C, Østergaard M, Poggenborg RP, Bøyesen P, Hammer HB, Boonen A, Pedersen SJ, Sørensen IJ, Madsen OR, Slot O, Møller JM, Szkudlarek M, Terslev L. Do tender joints in active psoriatic arthritis reflect inflammation assessed by ultrasound and magnetic resonance imaging? Rheumatology (Oxford) 2021; 61:723-733. [PMID: 33895799 DOI: 10.1093/rheumatology/keab384] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 04/21/2021] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To investigate the association between clinical joint tenderness and intra- and periarticular inflammation as assessed by ultrasound and magnetic resonance imaging (MRI) in patients with active psoriatic arthritis (PsA) and to explore if the associations differ according to patient-reported outcomes (PROs) and structural damage. METHODS Forty-one patients with active PsA and hand involvement had 76/78 joints examined for swelling/tenderness and ultrasound and MRI of 24 and 12 finger joints, respectively. Synovitis, tenosynovitis, periarticular inflammation and erosions were assessed using OMERACT definitions and scoring systems. Correlation between imaging inflammation sum-scores (intra-and periarticular) and tender/swollen joint counts were calculated using Spearman's rho, agreement at joint level was examined using prevalence and bias adjusted kappa (PABAK). Subgroup analyses explored the influence of PROs and radiographic erosive disease on these associations. RESULTS No significant correlations were found between tender or swollen joint counts and imaging inflammation sum-scores (rho=-0.31-0.38). In patients with higher level of overall pain, disability and lower self-reported mental health, a tendency towards negative correlations were found. At joint level, intra- and periarticular imaging inflammatory lesions had slight agreement with joint tenderness (PABAK=0.02-0.19) and slight to moderate with swelling (PABAK=0.16-0.54). For tender joints, agreement with imaging inflammation was even weaker in patients with either high overall pain scores, high disability scores, and/or non-erosive disease. CONCLUSION Joint tenderness had low association with imaging signs of inflammation in PsA patients, particularly in patients with high self-reported pain, disability and low mental health, indicating that tenderness is influenced by other parameters than local inflammation.
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Affiliation(s)
- Sara Kamp Felbo
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup
- Center for Rheumatology and Spine Diseases, Rigshospitalet
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | - Mikkel Østergaard
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup
- Center for Rheumatology and Spine Diseases, Rigshospitalet
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - René Panduro Poggenborg
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup
| | - Pernille Bøyesen
- Department of Rheumatology, Oslo University Hospital, Rikshospitalet
| | - Hilde Berner Hammer
- Department of Rheumatology, Diakonhjemmet Hospital
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Annelies Boonen
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center
- Care and Public Health Research Institute (CAPHRI), Maastricht University, The Netherlands
| | | | | | - Ole Rintek Madsen
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Center for Rheumatology and Spine Diseases, Gentofte Hospital, Gentofte
| | - Ole Slot
- Center for Rheumatology and Spine Diseases, Rigshospitalet
| | | | - Marcin Szkudlarek
- Department of Rheumatology, Zealand's University Hospital Køge, Køge, Denmark
| | - Lene Terslev
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup
- Center for Rheumatology and Spine Diseases, Rigshospitalet
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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6
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Østergaard M, Peterfy CG, Bird P, Gandjbakhch F, Glinatsi D, Eshed I, Haavardsholm EA, Lillegraven S, Bøyesen P, Ejbjerg B, Foltz V, Emery P, Genant HK, Conaghan PG. The OMERACT Rheumatoid Arthritis Magnetic Resonance Imaging (MRI) Scoring System: Updated Recommendations by the OMERACT MRI in Arthritis Working Group. J Rheumatol 2017; 44:1706-1712. [DOI: 10.3899/jrheum.161433] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2017] [Indexed: 02/08/2023]
Abstract
Objective.The Outcome Measures in Rheumatology (OMERACT) Rheumatoid Arthritis (RA) Magnetic Resonance Imaging (MRI) scoring system (RAMRIS), evaluating bone erosion, bone marrow edema/osteitis, and synovitis, was introduced in 2002, and is now the standard method of objectively quantifying inflammation and damage by MRI in RA trials. The objective of this paper was to identify subsequent advances and based on them, to provide updated recommendations for the RAMRIS.Methods.MRI studies relevant for RAMRIS and technical and scientific advances were analyzed by the OMERACT MRI in Arthritis Working Group, which used these data to provide updated considerations on image acquisition, RAMRIS definitions, and scoring systems for the original and new RA pathologies. Further, a research agenda was outlined.Results.Since 2002, longitudinal studies and clinical trials have documented RAMRIS variables to have face, construct, and criterion validity; high reliability and sensitivity to change; and the ability to discriminate between therapies. This has enabled RAMRIS to demonstrate inhibition of structural damage progression with fewer patients and shorter followup times than has been possible with conventional radiography. Technical improvements, including higher field strengths and improved pulse sequences, allow higher image resolution and contrast-to-noise ratio. These have facilitated development and validation of scoring methods of new pathologies: joint space narrowing and tenosynovitis. These have high reproducibility and moderate sensitivity to change, and can be added to RAMRIS. Combined scores of inflammation or joint damage may increase sensitivity to change and discriminative power. However, this requires further research.Conclusion.Updated 2016 RAMRIS recommendations and a research agenda were developed.
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Brinkmann GH, Norli ES, Bøyesen P, van der Heijde D, Grøvle L, Haugen AJ, Nygaard H, Bjørneboe O, Thunem C, Kvien TK, Mjaavatten MD, Lie E. Role of erosions typical of rheumatoid arthritis in the 2010 ACR/EULAR rheumatoid arthritis classification criteria: results from a very early arthritis cohort. Ann Rheum Dis 2017; 76:1911-1914. [PMID: 28798051 DOI: 10.1136/annrheumdis-2017-211350] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 05/31/2017] [Accepted: 07/05/2017] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To determine how the European League Against Rheumatism (EULAR) definition of erosive disease (erosion criterion) contributes to the number of patients classified as rheumatoid arthritis (RA) according to the 2010 American College of Rheumatology/EULAR RA classification criteria (2010 RA criteria) in an early arthritis cohort. METHODS Patients from the observational study Norwegian Very Early Arthritis Clinic with joint swelling ≤16 weeks, a clinical diagnosis of RA or undifferentiated arthritis, and radiographs of hands and feet were included. Erosive disease was defined according to the EULAR definition accompanying the 2010 RA criteria. We calculated the additional number of patients being classified as RA based on the erosion criteria at baseline and during follow-up. RESULTS Of the 289 included patients, 120 (41.5%) fulfilled the 2010 RA criteria, whereas 15 (5.2%) fulfilled only the erosion criterion at baseline. 118 patients had radiographic follow-up at 2 years, of whom 6.8% fulfilled the 2010 RA criteria and only one patient fulfilled solely the erosion criterion during follow-up. CONCLUSION Few patients with early arthritis were classified as RA based on solely the erosion criteria, and of those who did almost all did so at baseline.
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Affiliation(s)
- Gina Hetland Brinkmann
- Department of Rheumatology, Østfold Hospital Truststfold Hospital Trust, Grålum, Norway.,Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Ellen S Norli
- Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.,Department of Rheumatology, Martina Hansen Hospital, Bærum, Norway
| | - Pernille Bøyesen
- Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | | | - Lars Grøvle
- Department of Rheumatology, Østfold Hospital Truststfold Hospital Trust, Grålum, Norway
| | - Anne J Haugen
- Department of Rheumatology, Østfold Hospital Truststfold Hospital Trust, Grålum, Norway
| | - Halvor Nygaard
- Department of Rheumatology, Lillehammer Hospital for Rheumatic Diseases, Lillehammer, Norway
| | - Olav Bjørneboe
- Department of Rheumatology, Martina Hansen Hospital, Bærum, Norway
| | - Cathrine Thunem
- Department of Rheumatology, Betanien Hospital, Skien, Norway
| | - Tore K Kvien
- Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | | | - Elisabeth Lie
- Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
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8
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Haugen IK, Mathiessen A, Slatkowsky-Christensen B, Magnusson K, Bøyesen P, Sesseng S, van der Heijde D, Kvien TK, Hammer HB. Synovitis and radiographic progression in non-erosive and erosive hand osteoarthritis: is erosive hand osteoarthritis a separate inflammatory phenotype? Osteoarthritis Cartilage 2016; 24:647-54. [PMID: 26620088 DOI: 10.1016/j.joca.2015.11.014] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Revised: 10/30/2015] [Accepted: 11/17/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To compare the prevalence of synovitis, pain and radiographic progression in non-erosive and erosive hand osteoarthritis (HOA), and to explore whether the different rate of disease progression is explained by different levels of synovitis and structural damage. DESIGN We included 31 and 34 participants with non-erosive and erosive HOA at baseline, respectively. Using Generalized Estimating Equations, we explored whether participants with erosive HOA had more synovitis (by MRI, ultrasound and clinical examination) independent of the degree of structural damage. Similarly, we explored whether pain at baseline and radiographic progression after 5 years were higher in erosive HOA, independent of the levels of synovitis and structural damage. All analyses were adjusted for age and sex. RESULTS Power Doppler activity was found mainly in erosive HOA. Participants with erosive HOA demonstrated more moderate-to-severe synovitis, assessed by MRI (OR = 1.73, 95% CI 1.11-2.70), grey-scale ultrasound (OR = 2.02, 95% CI 1.25-3.26) and clinical examination (OR = 1.80, 95% CI 1.44-2.25). The associations became non-significant when adjusting for more structural damage. The higher frequency of joint tenderness in erosive HOA was at least partly explained more structural damage and inflammation. Radiographic progression (OR = 2.53, 95% CI 1.73-3.69) was more common in erosive HOA independent of radiographic HOA severity and synovitis (here: adjusted for grey-scale synovitis by ultrasound). CONCLUSION Erosive HOA is characterized by higher frequency and more severe synovitis, pain and radiographic progression compared to non-erosive HOA. The higher rate of disease progression was independent of baseline synovitis and structural damage.
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Affiliation(s)
- I K Haugen
- Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
| | - A Mathiessen
- Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
| | | | - K Magnusson
- National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
| | - P Bøyesen
- Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
| | - S Sesseng
- Department of Radiology, Diakonhjemmet Hospital, Oslo, Norway; Department of Radiology, Kongsvinger Hospital, Oslo, Norway
| | - D van der Heijde
- Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
| | - T K Kvien
- Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
| | - H B Hammer
- Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
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Ørnbjerg LM, Østergaard M, Jensen T, Hyldstrup L, Bach-Mortensen P, Bøyesen P, Thormann A, Tarp U, Bøhme WP, Lindegaard H, Poulsen UE, Schlemmer A, Graudal N, Rødgaard A, Espesen J, Kollerup GB, Glintborg B, Madsen OR, Jensen DV, Hetland ML. Establishment of age- and sex-adjusted reference data for hand bone mass and investigation of hand bone loss in patients with rheumatoid arthritis treated in clinical practice: an observational study from the DANBIO registry and the Copenhagen Osteoarthritis Study. Arthritis Res Ther 2016; 18:53. [PMID: 26912229 PMCID: PMC4766711 DOI: 10.1186/s13075-016-0952-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 02/08/2016] [Indexed: 12/31/2022] Open
Abstract
Background Rheumatoid arthritis is characterised by progressive joint destruction and loss of periarticular bone mass. Hand bone loss (HBL) has therefore been proposed as an outcome measure for treatment efficacy. A definition of increased HBL adjusted for age- and sex-related bone loss is lacking. In this study, we aimed to: 1) establish reference values for normal hand bone mass (bone mineral density measured by digital x-ray radiogrammetry (DXR-BMD)); and 2) examine whether HBL is normalised in rheumatoid arthritis patients during treatment with tumour necrosis factor alpha inhibitors (TNFI). Methods DXR-BMD was measured from hand x-rays in a reference cohort (1485 men/2541 women) without arthritis randomly selected from an urban Danish population. Sex- and age-related HBL/year was estimated. DXR-BMD was measured in rheumatoid arthritis patients (n = 350: at start of TNFI, and ~2 years after TNFI start), of which 135 patients had three x-rays (~2 years prior to TNFI, at start of TNFI, and ~2 years after TNFI start). Individual HBL/year prior to and during TNFI was calculated and compared to reference values. Results Estimated HBL/year varied strongly with age and sex. Compared to the reference values, 75 % of 135 patients had increased HBL prior to TNFI treatment and 59 % had increased HBL during TNFI treatment (p = 0.17, Chi-squared). In 38 % (38/101) of patients with increased HBL, HBL was normalised during TNFI treatment, whereas 47 % (16/34) of patients with normal HBL prior to TNFI had increased HBL during TNFI treatment. In the 350 patients, increased HBL during TNFI was associated with time-averaged 28-joint disease activity score (odds ratio 1.69 (95 % Confidence Interval 1.34-2.15)/unit increase, p < 0.001), and patients in time-averaged remission had lower HBL than patients without remission (0.0032 vs. 0.0058 g/cm2/year; p < 0.001, Mann-Whitney). Conclusions We established age- and sex-specific reference values for DXR-BMD in a large cohort without arthritis. HBL was increased in the majority of rheumatoid arthritis patients initiating TNFI in clinical practice, and only normalised in a minority during TNFI. Electronic supplementary material The online version of this article (doi:10.1186/s13075-016-0952-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lykke Midtbøll Ørnbjerg
- DANBIO registry and Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Ndr. Ringvej 57, DK-2600, Glostrup, Denmark. .,Rigshospitalet, Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Mikkel Østergaard
- DANBIO registry and Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Ndr. Ringvej 57, DK-2600, Glostrup, Denmark. .,Rigshospitalet, Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Trine Jensen
- Department of Endocrinology, Hvidovre Hospital, Hvidovre, Denmark.
| | - Lars Hyldstrup
- Department of Endocrinology, Hvidovre Hospital, Hvidovre, Denmark.
| | | | - Pernille Bøyesen
- Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
| | - Anja Thormann
- DANBIO registry and Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Ndr. Ringvej 57, DK-2600, Glostrup, Denmark.
| | - Ulrik Tarp
- Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark.
| | | | - Hanne Lindegaard
- Department of Rheumatology, Odense University Hospital, Odense, Denmark.
| | | | - Anette Schlemmer
- Department of Rheumatology, Aalborg University Hospital, Aalborg, Denmark.
| | - Niels Graudal
- Department of Infectious Diseases and Rheumatology, Copenhagen University Hospital Rigshospitalet Blegdamsvej, Copenhagen, Denmark.
| | - Anne Rødgaard
- Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, Glostrup, Denmark.
| | - Jakob Espesen
- Department of Internal Medicine, Lillebælt Hospital, Vejle, Denmark.
| | - Gina Birgitte Kollerup
- Department of Rheumatology, Copenhagen University Hospital Bispebjerg and Frederiksberg, Copenhagen, Denmark.
| | - Bente Glintborg
- Department of Internal Medicine, Holbæk Hospital, Holbæk, Denmark.
| | - Ole Rintek Madsen
- Department of Medicine and Rheumatology, Copenhagen University Hospital Gentofte, Gentofte, Denmark.
| | | | - Merete Lund Hetland
- DANBIO registry and Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Ndr. Ringvej 57, DK-2600, Glostrup, Denmark. .,Rigshospitalet, Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
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Haugeberg G, Bøyesen P, Helgetveit K, Prøven A. Clinical and Radiographic Outcomes in Patients Diagnosed with Early Rheumatoid Arthritis in the First Years of the Biologic Treatment Era: A 10-year Prospective Observational Study. J Rheumatol 2015; 42:2279-87. [PMID: 26568592 DOI: 10.3899/jrheum.150384] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2015] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To study short-term and longterm clinical and radiographic outcomes in patients with early rheumatoid arthritis (RA) in the first decade of the biologic treatment era. METHODS Patients with early RA diagnosed at a rheumatology outpatient clinic were consecutively enrolled between 1999 and 2001. Data were collected on demographic characteristics, disease activity, patient-reported outcomes, and treatments. Radiographs of hands and feet were performed at baseline and after 2, 5, and 10 years and scored according to the Sharp/van der Heijde method, yielding a modified total Sharp score (mTSS). RESULTS Mean baseline age for the 94 included patients (36 men and 58 women) was 50.4 years and symptom duration 12.3 months; 67.8% were rheumatoid factor-positive. The proportion of patients in remission and in low, moderate, and high disease activity status was at baseline 4.3%, 1.1%, 35.1%, and 59.6% and at 10 years 52.1%, 20.5%, 27.4%, and 0.0%, respectively. For the period 0-2 years, 62.8% had used prednisolone, 91.5% synthetic disease-modifying antirheumatic drug (DMARD), and 18.1% biologic DMARD, and for the period 2-10 years the numbers were 50.6%, 89.3%, and 62.7%, respectively. At baseline, 70% of the patients had erosions on radiographs. Mean annual change in mTSS was for 0-2 years 3.4, 2-5 years 1.7, and 5-10 years 1.2. CONCLUSION A large proportion of our patients with RA diagnosed and treated in the new biologic treatment era achieved a status of clinical remission or low disease activity and had only a minor increase in radiographic joint damage after the first years of followup.
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Affiliation(s)
- Glenn Haugeberg
- From the Department of Rheumatology, Hospital of Southern Norway Trust, Kristiansand; Norwegian University of Science and Technology, Trondheim; Department of Rheumatology, Diakonhjemmet Hospital, Oslo; Department of Rheumatology, Martina Hansens Hospital, Bærum, Norway.G. Haugeberg, MD, PhD, consultant, Department of Rheumatology, Hospital of Southern Norway Trust, professor, Norwegian University of Science and Technology; P. Bøyesen, MD, PhD, assistant doctor, Department of Rheumatology, Diakonhjemmet Hospital; K. Helgetveit, MD, Department of Rheumatology, Martina Hansens Hospital; A. Prøven, MD, Department of Rheumatology, Martina Hansens Hospital.
| | - Pernille Bøyesen
- From the Department of Rheumatology, Hospital of Southern Norway Trust, Kristiansand; Norwegian University of Science and Technology, Trondheim; Department of Rheumatology, Diakonhjemmet Hospital, Oslo; Department of Rheumatology, Martina Hansens Hospital, Bærum, Norway.G. Haugeberg, MD, PhD, consultant, Department of Rheumatology, Hospital of Southern Norway Trust, professor, Norwegian University of Science and Technology; P. Bøyesen, MD, PhD, assistant doctor, Department of Rheumatology, Diakonhjemmet Hospital; K. Helgetveit, MD, Department of Rheumatology, Martina Hansens Hospital; A. Prøven, MD, Department of Rheumatology, Martina Hansens Hospital
| | - Knut Helgetveit
- From the Department of Rheumatology, Hospital of Southern Norway Trust, Kristiansand; Norwegian University of Science and Technology, Trondheim; Department of Rheumatology, Diakonhjemmet Hospital, Oslo; Department of Rheumatology, Martina Hansens Hospital, Bærum, Norway.G. Haugeberg, MD, PhD, consultant, Department of Rheumatology, Hospital of Southern Norway Trust, professor, Norwegian University of Science and Technology; P. Bøyesen, MD, PhD, assistant doctor, Department of Rheumatology, Diakonhjemmet Hospital; K. Helgetveit, MD, Department of Rheumatology, Martina Hansens Hospital; A. Prøven, MD, Department of Rheumatology, Martina Hansens Hospital
| | - Anne Prøven
- From the Department of Rheumatology, Hospital of Southern Norway Trust, Kristiansand; Norwegian University of Science and Technology, Trondheim; Department of Rheumatology, Diakonhjemmet Hospital, Oslo; Department of Rheumatology, Martina Hansens Hospital, Bærum, Norway.G. Haugeberg, MD, PhD, consultant, Department of Rheumatology, Hospital of Southern Norway Trust, professor, Norwegian University of Science and Technology; P. Bøyesen, MD, PhD, assistant doctor, Department of Rheumatology, Diakonhjemmet Hospital; K. Helgetveit, MD, Department of Rheumatology, Martina Hansens Hospital; A. Prøven, MD, Department of Rheumatology, Martina Hansens Hospital
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Glinatsi D, Bird P, Gandjbakhch F, Mease PJ, Bøyesen P, Peterfy CG, Conaghan PG, Østergaard M. Validation of the OMERACT Psoriatic Arthritis Magnetic Resonance Imaging Score (PsAMRIS) for the Hand and Foot in a Randomized Placebo-controlled Trial. J Rheumatol 2015; 42:2473-9. [PMID: 26523032 DOI: 10.3899/jrheum.141010] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To assess changes following treatment and the reliability and responsiveness to change of the Outcome Measures in Rheumatology (OMERACT) Psoriatic Arthritis Magnetic Resonance Imaging Score (PsAMRIS) in a randomized controlled trial. METHODS Forty patients with PsA randomized to either placebo or abatacept (ABA) had MRI of either 1 hand (n = 20) or 1 foot (n = 20) at baseline and after 6 months. Images were scored blindly twice by 3 independent readers according to the PsAMRIS (for synovitis, tenosynovitis, periarticular inflammation, bone edema, bone erosion, and bone proliferation). RESULTS Inflammatory features improved numerically but statistically nonsignificantly in the ABA group but not the placebo group. Baseline intrareader intraclass correlation coefficients (ICC) were good (≥ 0.50) to very good (≥ 0.80) for all features in both hand and foot. Baseline interreader ICC were good (ICC 0.72-0.96) for all features, except periarticular inflammation and bone proliferation in the hand and tenosynovitis in the foot (ICC 0.25-0.44). Intrareader and interreader ICC for change scores varied. Guyatt's responsiveness index (GRI) was high for inflammatory features in the hand and metatarsophalangeal joints (GRI -0.67 to -3.13; bone edema not calculable). Minimal change and low prevalence resulted in low ICC and GRI for bone damage. CONCLUSION PsAMRIS showed overall good intrareader agreement in the hand and foot, and inflammatory feature scores were responsive to change, suggesting that PsAMRIS may be a valid tool for MRI assessment of hands and feet in PsA clinical trials.
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Affiliation(s)
- Daniel Glinatsi
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet-Glostrup, University of Copenhagen; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; University of NSW, Sydney, Australia; Pitié Salpêtrière Hospital, APHP, Université Paris 6-UPMC, Paris, France; Swedish Medical Center and University of Washington, Seattle, Washington, USA; Diakonhjemmet Hospital, Oslo, Norway; Spire Sciences Inc., Boca Raton, Florida, USA; and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK.D. Glinatsi, MD, Research Fellow, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet-Glostrup, University of Copenhagen; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of NSW; F. Gandjbakhch, MD, Practicing Rheumatologist, Department of Rheumatology, Pitié Salpêtrière Hospital, APHP, Université Paris 6-UPMC; P.J. Mease, MD, Swedish Medical Center and University of Washington; P. Bøyesen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; C.G. Peterfy, MD, PhD, FRCP, Chief Executive Officer, Spire Sciences Inc.; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Musculoskeletal Biomedical Research Unit; M. Østergaard, MD, PhD, DMSc, Professor of Rheumatology, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet-Glostrup and Department of Clinical Medicine, University of Copenhagen.
| | - Paul Bird
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet-Glostrup, University of Copenhagen; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; University of NSW, Sydney, Australia; Pitié Salpêtrière Hospital, APHP, Université Paris 6-UPMC, Paris, France; Swedish Medical Center and University of Washington, Seattle, Washington, USA; Diakonhjemmet Hospital, Oslo, Norway; Spire Sciences Inc., Boca Raton, Florida, USA; and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK.D. Glinatsi, MD, Research Fellow, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet-Glostrup, University of Copenhagen; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of NSW; F. Gandjbakhch, MD, Practicing Rheumatologist, Department of Rheumatology, Pitié Salpêtrière Hospital, APHP, Université Paris 6-UPMC; P.J. Mease, MD, Swedish Medical Center and University of Washington; P. Bøyesen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; C.G. Peterfy, MD, PhD, FRCP, Chief Executive Officer, Spire Sciences Inc.; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Musculoskeletal Biomedical Research Unit; M. Østergaard, MD, PhD, DMSc, Professor of Rheumatology, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet-Glostrup and Department of Clinical Medicine, University of Copenhagen
| | - Frederique Gandjbakhch
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet-Glostrup, University of Copenhagen; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; University of NSW, Sydney, Australia; Pitié Salpêtrière Hospital, APHP, Université Paris 6-UPMC, Paris, France; Swedish Medical Center and University of Washington, Seattle, Washington, USA; Diakonhjemmet Hospital, Oslo, Norway; Spire Sciences Inc., Boca Raton, Florida, USA; and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK.D. Glinatsi, MD, Research Fellow, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet-Glostrup, University of Copenhagen; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of NSW; F. Gandjbakhch, MD, Practicing Rheumatologist, Department of Rheumatology, Pitié Salpêtrière Hospital, APHP, Université Paris 6-UPMC; P.J. Mease, MD, Swedish Medical Center and University of Washington; P. Bøyesen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; C.G. Peterfy, MD, PhD, FRCP, Chief Executive Officer, Spire Sciences Inc.; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Musculoskeletal Biomedical Research Unit; M. Østergaard, MD, PhD, DMSc, Professor of Rheumatology, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet-Glostrup and Department of Clinical Medicine, University of Copenhagen
| | - Philip J Mease
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet-Glostrup, University of Copenhagen; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; University of NSW, Sydney, Australia; Pitié Salpêtrière Hospital, APHP, Université Paris 6-UPMC, Paris, France; Swedish Medical Center and University of Washington, Seattle, Washington, USA; Diakonhjemmet Hospital, Oslo, Norway; Spire Sciences Inc., Boca Raton, Florida, USA; and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK.D. Glinatsi, MD, Research Fellow, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet-Glostrup, University of Copenhagen; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of NSW; F. Gandjbakhch, MD, Practicing Rheumatologist, Department of Rheumatology, Pitié Salpêtrière Hospital, APHP, Université Paris 6-UPMC; P.J. Mease, MD, Swedish Medical Center and University of Washington; P. Bøyesen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; C.G. Peterfy, MD, PhD, FRCP, Chief Executive Officer, Spire Sciences Inc.; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Musculoskeletal Biomedical Research Unit; M. Østergaard, MD, PhD, DMSc, Professor of Rheumatology, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet-Glostrup and Department of Clinical Medicine, University of Copenhagen
| | - Pernille Bøyesen
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet-Glostrup, University of Copenhagen; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; University of NSW, Sydney, Australia; Pitié Salpêtrière Hospital, APHP, Université Paris 6-UPMC, Paris, France; Swedish Medical Center and University of Washington, Seattle, Washington, USA; Diakonhjemmet Hospital, Oslo, Norway; Spire Sciences Inc., Boca Raton, Florida, USA; and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK.D. Glinatsi, MD, Research Fellow, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet-Glostrup, University of Copenhagen; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of NSW; F. Gandjbakhch, MD, Practicing Rheumatologist, Department of Rheumatology, Pitié Salpêtrière Hospital, APHP, Université Paris 6-UPMC; P.J. Mease, MD, Swedish Medical Center and University of Washington; P. Bøyesen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; C.G. Peterfy, MD, PhD, FRCP, Chief Executive Officer, Spire Sciences Inc.; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Musculoskeletal Biomedical Research Unit; M. Østergaard, MD, PhD, DMSc, Professor of Rheumatology, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet-Glostrup and Department of Clinical Medicine, University of Copenhagen
| | - Charles G Peterfy
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet-Glostrup, University of Copenhagen; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; University of NSW, Sydney, Australia; Pitié Salpêtrière Hospital, APHP, Université Paris 6-UPMC, Paris, France; Swedish Medical Center and University of Washington, Seattle, Washington, USA; Diakonhjemmet Hospital, Oslo, Norway; Spire Sciences Inc., Boca Raton, Florida, USA; and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK.D. Glinatsi, MD, Research Fellow, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet-Glostrup, University of Copenhagen; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of NSW; F. Gandjbakhch, MD, Practicing Rheumatologist, Department of Rheumatology, Pitié Salpêtrière Hospital, APHP, Université Paris 6-UPMC; P.J. Mease, MD, Swedish Medical Center and University of Washington; P. Bøyesen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; C.G. Peterfy, MD, PhD, FRCP, Chief Executive Officer, Spire Sciences Inc.; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Musculoskeletal Biomedical Research Unit; M. Østergaard, MD, PhD, DMSc, Professor of Rheumatology, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet-Glostrup and Department of Clinical Medicine, University of Copenhagen
| | - Philip G Conaghan
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet-Glostrup, University of Copenhagen; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; University of NSW, Sydney, Australia; Pitié Salpêtrière Hospital, APHP, Université Paris 6-UPMC, Paris, France; Swedish Medical Center and University of Washington, Seattle, Washington, USA; Diakonhjemmet Hospital, Oslo, Norway; Spire Sciences Inc., Boca Raton, Florida, USA; and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK.D. Glinatsi, MD, Research Fellow, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet-Glostrup, University of Copenhagen; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of NSW; F. Gandjbakhch, MD, Practicing Rheumatologist, Department of Rheumatology, Pitié Salpêtrière Hospital, APHP, Université Paris 6-UPMC; P.J. Mease, MD, Swedish Medical Center and University of Washington; P. Bøyesen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; C.G. Peterfy, MD, PhD, FRCP, Chief Executive Officer, Spire Sciences Inc.; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Musculoskeletal Biomedical Research Unit; M. Østergaard, MD, PhD, DMSc, Professor of Rheumatology, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet-Glostrup and Department of Clinical Medicine, University of Copenhagen
| | - Mikkel Østergaard
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet-Glostrup, University of Copenhagen; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; University of NSW, Sydney, Australia; Pitié Salpêtrière Hospital, APHP, Université Paris 6-UPMC, Paris, France; Swedish Medical Center and University of Washington, Seattle, Washington, USA; Diakonhjemmet Hospital, Oslo, Norway; Spire Sciences Inc., Boca Raton, Florida, USA; and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK.D. Glinatsi, MD, Research Fellow, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet-Glostrup, University of Copenhagen; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of NSW; F. Gandjbakhch, MD, Practicing Rheumatologist, Department of Rheumatology, Pitié Salpêtrière Hospital, APHP, Université Paris 6-UPMC; P.J. Mease, MD, Swedish Medical Center and University of Washington; P. Bøyesen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; C.G. Peterfy, MD, PhD, FRCP, Chief Executive Officer, Spire Sciences Inc.; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Musculoskeletal Biomedical Research Unit; M. Østergaard, MD, PhD, DMSc, Professor of Rheumatology, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet-Glostrup and Department of Clinical Medicine, University of Copenhagen
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Visser AW, Bøyesen P, Haugen IK, Schoones JW, van der Heijde DM, Rosendaal FR, Kloppenburg M. Instruments Measuring Pain, Physical Function, or Patient’s Global Assessment in Hand Osteoarthritis: A Systematic Literature Search. J Rheumatol 2015; 42:2118-34. [DOI: 10.3899/jrheum.141228] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2015] [Indexed: 11/22/2022]
Abstract
Objective.Description of use and metric properties of instruments measuring pain, physical function, or patient’s global assessment (PtGA) in hand osteoarthritis (OA).Methods.Medical literature databases up to January 2014 were systematically reviewed for studies reporting on instruments measuring pain, physical function, or PtGA in hand OA. The frequency of the use of these instruments were described, as well as their metric properties, including discrimination (reliability, sensitivity to change), feasibility, and validity.Results.In 66 included studies, various questionnaires and performance- or assessor-based instruments were applied for evaluation of pain, physical function, or PtGA. No major differences regarding metric properties were observed between the instruments, although the amount of supporting evidence varied. The most frequently evaluated questionnaires were the Australian/Canadian Hand OA Index (AUSCAN) pain subscale and visual analog scale (VAS) pain for pain assessment, and the AUSCAN function subscale and Functional Index for Hand OA (FIHOA) for physical function assessment. Excellent reliability was shown for the AUSCAN and FIHOA, and good sensitivity to change for all mentioned instruments; additionally, the FIHOA had good feasibility. Good construct validity was suggested for all mentioned questionnaires. The most commonly applied performance- or assessor-based instruments were the grip and pinch strength for the assessment of physical function, and the assessment of pain by palpation. For these measures, good sensitivity to change and construct validity were established.Conclusion.The AUSCAN, FIHOA, VAS pain, grip and pinch strength, and pain on palpation were most frequently used and provided most supporting evidence for good metric properties. More research has to be performed to compare the different instruments with each other.
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Haugen IK, Eshed I, Gandjbakhch F, Foltz V, Østergaard M, Bøyesen P, Bird P, Genant HK, Peterfy CG, Conaghan PG. The Longitudinal Reliability and Responsiveness of the OMERACT Hand Osteoarthritis Magnetic Resonance Imaging Scoring System (HOAMRIS). J Rheumatol 2015; 42:2486-91. [DOI: 10.3899/jrheum.140983] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objective.To evaluate the interreader reliability of change scores and the responsiveness of the OMERACT Hand Osteoarthritis (OA) Magnetic Resonance Image (MRI) Scoring System (HOAMRIS).Methods.Paired MRI (baseline and 5-yr followup) from 20 patients with hand OA were scored with known time sequence by 3 readers according to the HOAMRIS: Synovitis, erosive damage, cysts, osteophytes, cartilage space loss, malalignment, and bone marrow lesions (BML; 0–3 scales with 0.5 increments for synovitis, erosive damage, and BML). Interreader reliability for status and change scores were assessed by intraclass correlation coefficients (ICC), percentage exact agreement and percentage close agreement (PEA/PCA), and smallest detectable change (SDC). Responsiveness was assessed by standardized response means (SRM).Results.Cross-sectional interreader ICC were good to very good (≥ 0.74) for all features except synovitis, cysts, and malalignment (ICC 0.50–0.58). The range of change values was small, leading to low ICC for change scores. The SDC values for sum scores (total range 0–24) varied between 1.97–3.05 (except 1.08 for malalignment). For status scores, PEA/PCA on scores in individual joints across the readers were 8.1–50.0 and 43.8–78.1, respectively. Similarly, PEA/PCA for change scores were 20.6–63.8 and 66.3–93.1, respectively. All features except cysts and BML demonstrated good responsiveness with higher SRM for sum scores (range 0.46–1.62) than for scores in individual joints (range 0.24–0.73).Conclusion.Good to very good interreader ICC values were found for cross-sectional readings, whereas the longitudinal reliability was lower because of a smaller range of change scores. All features, except cysts and BML, showed good responsiveness.
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Kloppenburg M, Bøyesen P, Visser AW, Haugen IK, Boers M, Boonen A, Conaghan PG, Hawker GA, Kvien TK, Landewé R, Uhlig T, Smeets W, Greibrokk E, van der Heijde DM. Report from the OMERACT Hand Osteoarthritis Working Group: Set of Core Domains and Preliminary Set of Instruments for Use in Clinical Trials and Observational Studies. J Rheumatol 2015; 42:2190-7. [DOI: 10.3899/jrheum.141017] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objective.During OMERACT 12, a workshop was held with the aim to endorse a core set of domains for 3 settings: clinical trials of symptom and structure modification and observational studies. Additional goals were to endorse a core set of contextual factors for these settings, and to define preliminary instruments for each core domain. Finally, an agenda for future research in hand osteoarthritis (OA) was to be proposed.Methods.Literature reviews of preliminary instruments for each core domain of the proposed core set for hand OA in the settings described above. Literature review of radiographic scoring methods and modern imaging in hand OA were also performed. Proposed contextual factors for a core set were identified through 2 Delphi exercises with participation of hand OA experts, patient partners, and OMERACT participants.Results.Results from Delphi exercises and systematic literature reviews were presented and discussed. It was agreed that a preliminary core domain set for the setting clinical trials of symptom modification should contain at least “pain, physical function, patient global assessment, joint activity and hand strength.” The settings clinical trial of structure modification and observational studies would in addition include structural damage. Preliminary instruments for the proposed domains were agreed on. A list of prioritized contextual factors was defined and endorsed for further research. A research agenda was proposed for domain instrument validation according to the OMERACT Filter 2.0.Conclusion.Preliminary core sets for clinical trials of symptom and structure modification and observational studies in hand osteoarthritis, including preliminary instruments and contextual factors, were agreed upon during OMERACT 12.
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Ørnbjerg L, Østergaard M, Jensen T, Hyldstrup L, Bach-Mortensen P, Bøyesen P, Thormann A, Tarp U, Lindegaard H, Schlemmer A, Graudal N, Andersen A, Espesen J, Kollerup G, Glintborg B, Madsen O, Jensen D, Hetland M. SAT0079 Tumour Necrosis Factor Alpha Inhibitor Treatment Normalises Hand Bone Loss in a Minority of Rheumatoid Arthritis Patients Treated in Clinical Practice. Results from the Copenhagen Osteoarthritis Study and the Danbio Registry. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.1789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Haugen I, Mathiessen A, Slatkowsky-Christensen B, Bøyesen P, Sesseng S, van der Heijde D, Hammer H, Kvien T. THU0466 Erosive Hand Osteoarthritis (OA) is Characterized by More Synovitis and More Rapid Disease Progression. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.2223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Haugeberg G, Bøyesen P, Helgetveit K, Prøven A. FRI0039 Clinical and Radiographic Outcome in Early Rheumatoid Arthritis Patients Diagnosed in the First Years of the Biologic Treatment ERA – A 10 Year Prospective Observational Study:. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.2162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Kortekaas MC, Kwok WY, Reijnierse M, Wolterbeek R, Bøyesen P, van der Heijde D, Bloem JL, Kloppenburg M. Magnetic Resonance Imaging in Hand Osteoarthritis: Intraobserver Reliability and Criterion Validity for Clinical and Structural Characteristics. J Rheumatol 2015; 42:1224-30. [DOI: 10.3899/jrheum.140338] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2015] [Indexed: 12/17/2022]
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).Conclusion.MRI is a reliable and valid method to assess inflammatory and structural features in HOA. It gives additional information over radiographs and US.
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Haugen IK, Slatkowsky Christensen B, Bøyesen P, Sesseng S, van der Heijde D, Kvien TK. Increasing synovitis and bone marrow lesions are associated with incident joint tenderness in hand osteoarthritis. Ann Rheum Dis 2015; 75:702-8. [DOI: 10.1136/annrheumdis-2014-206829] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2014] [Accepted: 02/19/2015] [Indexed: 11/04/2022]
Abstract
ObjectivesTo explore whether changes of MRI-defined synovitis and bone marrow lesions (BMLs) are related to changes in joint tenderness in a 5-year longitudinal study of the Oslo hand osteoarthritis (OA) cohort.MethodsWe included 70 patients (63 women, mean (SD) age 67.9 (5.5) years). BMLs and contrast-enhanced synovitis in the distal and proximal interphalangeal joints were evaluated on 0–3 scales in n=69 and n=48 patients, respectively. Among joints without tenderness at baseline, we explored whether increasing/incident synovitis and BMLs were associated with incident joint tenderness using generalised estimating equations. Among joints with tenderness at baseline, we explored whether decreasing or resolution of synovitis and BMLs were associated with loss of joint tenderness. We adjusted for age, sex, body mass index, follow-up time and changes in radiographic OA.ResultsAmong joints without tenderness at baseline, increasing/incident synovitis and BMLs were seen in 45 of 220 (20.5%) and 47 of 312 (15.1%) joints, respectively. Statistically significant associations to incident joint tenderness were found for increasing/incident synovitis (OR=2.66, 95% CI 1.38 to 5.11) and BMLs (OR=2.85, 95% CI 1.23 to 6.58) independent of structural progression. We found a trend that resolution of synovitis (OR=1.72, 95% CI 0.80 to 3.68) and moderate/large decreases of BMLs (OR=1.90, 95% CI 0.57 to 6.33) were associated with loss of joint tenderness, but these associations were non-significant.ConclusionsThe Oslo hand OA cohort is the first study with longitudinal hand MRIs. Increasing synovitis and BMLs were significantly associated with incident joint tenderness, whereas no significant associations were found for decreasing or loss of synovitis and BMLs.
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Østergaard M, Bird P, Gandjbakhch F, Eshed I, Haugen IK, Haavardsholm EA, Lillegraven S, Foltz V, Glinatsi D, Peterfy C, Ejbjerg B, Bøyesen P, Mease PJ, Hermann KG, Emery P, Genant HK, Conaghan PG. The OMERACT MRI in Arthritis Working Group - Update on Status and Future Research Priorities. J Rheumatol 2015; 42:2470-2. [PMID: 25684771 DOI: 10.3899/jrheum.141248] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To provide an update on the status and future research priorities of the Outcome Measures in Rheumatology (OMERACT) magnetic resonance imaging (MRI) in arthritis working group. METHODS A summary is provided of the activities of the group within rheumatoid arthritis (RA), psoriatic arthritis (PsA), and osteoarthritis (OA), and its research priorities. RESULTS The OMERACT RA MRI score (RAMRIS) evaluating bone erosion, bone edema (osteitis), and synovitis is now the standard method of quantifying articular pathology in RA trials. Cartilage loss is another important part of joint damage, and at the OMERACT 12 conference, we provided longitudinal data demonstrating reliability and sensitivity to change of the RAMRIS JSN component score, supporting its use in future clinical trials. The MRI group has previously developed a PsA MRI score (PsAMRIS). At OMERACT 12, PsAMRIS was evaluated in a randomized placebo-controlled trial of patients with PsA, demonstrating the responsiveness and discriminatory ability of applying the PsAMRIS to hands and feet. A hand OA MRI score (HOAMRIS) was introduced at OMERACT 11, and has subsequently been further validated. At OMERACT 12, good cross-sectional interreader reliability, but variable reliability of change scores, were reported. Potential future research areas were identified at the MRI session at OMERACT 12 including assessment of tenosynovitis in RA and enthesitis in PsA and focusing on alternative MRI techniques. CONCLUSION MRI has been further developed and validated as an outcome measure in RA, PsA, and OA. The group will continue its efforts to optimize the value of MRI as a robust biomarker in rheumatology clinical trials.
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Affiliation(s)
- Mikkel Østergaard
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; University of New South Wales, Sydney, Australia; Department of Rheumatology, Pitié-Salpêtrière Hospital, APHP, Université Paris 6-UPMC, Paris, France; Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Spire Sciences, Boca Raton, Florida, USA; Department of Rheumatology, Slagelse Hospital, Slagelse, Denmark; Division of Rheumatology Research, Swedish Medical Center, University of Washington School of Medicine; and Seattle Rheumatology Associates, Seattle, Washington, USA; Department of Radiology, Charité University Hospital, Berlin, Germany; Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; University of California, San Francisco, and Synarc Inc., San Francisco, California, USA. M. Østergaard, MD, PhD, DMSc, Professor of Rheumatology, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital and Department of Clinical Medicine, University of Copenhagen; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip MRI, Senior Lecturer, University of NSW; F. Gandjbakhch, MD, Practicing Rheumatologist, Department of Rheumatology, Pitié-Salpêtrière, APHP, Université Paris 6-UPMC; I. Eshed, MD, Professor of Radiology, Sheba Medical Center, Tel Aviv University; I.K. Haugen, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital; E.A. Haavardsholm, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital; S. Lillegraven, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital, University of Oslo; V. Foltz, MD, Practicing Rheumatologist,
| | - Paul Bird
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; University of New South Wales, Sydney, Australia; Department of Rheumatology, Pitié-Salpêtrière Hospital, APHP, Université Paris 6-UPMC, Paris, France; Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Spire Sciences, Boca Raton, Florida, USA; Department of Rheumatology, Slagelse Hospital, Slagelse, Denmark; Division of Rheumatology Research, Swedish Medical Center, University of Washington School of Medicine; and Seattle Rheumatology Associates, Seattle, Washington, USA; Department of Radiology, Charité University Hospital, Berlin, Germany; Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; University of California, San Francisco, and Synarc Inc., San Francisco, California, USA. M. Østergaard, MD, PhD, DMSc, Professor of Rheumatology, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital and Department of Clinical Medicine, University of Copenhagen; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip MRI, Senior Lecturer, University of NSW; F. Gandjbakhch, MD, Practicing Rheumatologist, Department of Rheumatology, Pitié-Salpêtrière, APHP, Université Paris 6-UPMC; I. Eshed, MD, Professor of Radiology, Sheba Medical Center, Tel Aviv University; I.K. Haugen, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital; E.A. Haavardsholm, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital; S. Lillegraven, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital, University of Oslo; V. Foltz, MD, Practicing Rheumatologist,
| | - Frédérique Gandjbakhch
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; University of New South Wales, Sydney, Australia; Department of Rheumatology, Pitié-Salpêtrière Hospital, APHP, Université Paris 6-UPMC, Paris, France; Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Spire Sciences, Boca Raton, Florida, USA; Department of Rheumatology, Slagelse Hospital, Slagelse, Denmark; Division of Rheumatology Research, Swedish Medical Center, University of Washington School of Medicine; and Seattle Rheumatology Associates, Seattle, Washington, USA; Department of Radiology, Charité University Hospital, Berlin, Germany; Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; University of California, San Francisco, and Synarc Inc., San Francisco, California, USA. M. Østergaard, MD, PhD, DMSc, Professor of Rheumatology, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital and Department of Clinical Medicine, University of Copenhagen; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip MRI, Senior Lecturer, University of NSW; F. Gandjbakhch, MD, Practicing Rheumatologist, Department of Rheumatology, Pitié-Salpêtrière, APHP, Université Paris 6-UPMC; I. Eshed, MD, Professor of Radiology, Sheba Medical Center, Tel Aviv University; I.K. Haugen, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital; E.A. Haavardsholm, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital; S. Lillegraven, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital, University of Oslo; V. Foltz, MD, Practicing Rheumatologist,
| | - Iris Eshed
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; University of New South Wales, Sydney, Australia; Department of Rheumatology, Pitié-Salpêtrière Hospital, APHP, Université Paris 6-UPMC, Paris, France; Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Spire Sciences, Boca Raton, Florida, USA; Department of Rheumatology, Slagelse Hospital, Slagelse, Denmark; Division of Rheumatology Research, Swedish Medical Center, University of Washington School of Medicine; and Seattle Rheumatology Associates, Seattle, Washington, USA; Department of Radiology, Charité University Hospital, Berlin, Germany; Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; University of California, San Francisco, and Synarc Inc., San Francisco, California, USA. M. Østergaard, MD, PhD, DMSc, Professor of Rheumatology, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital and Department of Clinical Medicine, University of Copenhagen; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip MRI, Senior Lecturer, University of NSW; F. Gandjbakhch, MD, Practicing Rheumatologist, Department of Rheumatology, Pitié-Salpêtrière, APHP, Université Paris 6-UPMC; I. Eshed, MD, Professor of Radiology, Sheba Medical Center, Tel Aviv University; I.K. Haugen, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital; E.A. Haavardsholm, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital; S. Lillegraven, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital, University of Oslo; V. Foltz, MD, Practicing Rheumatologist,
| | - Ida K Haugen
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; University of New South Wales, Sydney, Australia; Department of Rheumatology, Pitié-Salpêtrière Hospital, APHP, Université Paris 6-UPMC, Paris, France; Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Spire Sciences, Boca Raton, Florida, USA; Department of Rheumatology, Slagelse Hospital, Slagelse, Denmark; Division of Rheumatology Research, Swedish Medical Center, University of Washington School of Medicine; and Seattle Rheumatology Associates, Seattle, Washington, USA; Department of Radiology, Charité University Hospital, Berlin, Germany; Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; University of California, San Francisco, and Synarc Inc., San Francisco, California, USA. M. Østergaard, MD, PhD, DMSc, Professor of Rheumatology, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital and Department of Clinical Medicine, University of Copenhagen; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip MRI, Senior Lecturer, University of NSW; F. Gandjbakhch, MD, Practicing Rheumatologist, Department of Rheumatology, Pitié-Salpêtrière, APHP, Université Paris 6-UPMC; I. Eshed, MD, Professor of Radiology, Sheba Medical Center, Tel Aviv University; I.K. Haugen, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital; E.A. Haavardsholm, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital; S. Lillegraven, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital, University of Oslo; V. Foltz, MD, Practicing Rheumatologist,
| | - Espen A Haavardsholm
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; University of New South Wales, Sydney, Australia; Department of Rheumatology, Pitié-Salpêtrière Hospital, APHP, Université Paris 6-UPMC, Paris, France; Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Spire Sciences, Boca Raton, Florida, USA; Department of Rheumatology, Slagelse Hospital, Slagelse, Denmark; Division of Rheumatology Research, Swedish Medical Center, University of Washington School of Medicine; and Seattle Rheumatology Associates, Seattle, Washington, USA; Department of Radiology, Charité University Hospital, Berlin, Germany; Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; University of California, San Francisco, and Synarc Inc., San Francisco, California, USA. M. Østergaard, MD, PhD, DMSc, Professor of Rheumatology, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital and Department of Clinical Medicine, University of Copenhagen; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip MRI, Senior Lecturer, University of NSW; F. Gandjbakhch, MD, Practicing Rheumatologist, Department of Rheumatology, Pitié-Salpêtrière, APHP, Université Paris 6-UPMC; I. Eshed, MD, Professor of Radiology, Sheba Medical Center, Tel Aviv University; I.K. Haugen, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital; E.A. Haavardsholm, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital; S. Lillegraven, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital, University of Oslo; V. Foltz, MD, Practicing Rheumatologist,
| | - Siri Lillegraven
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; University of New South Wales, Sydney, Australia; Department of Rheumatology, Pitié-Salpêtrière Hospital, APHP, Université Paris 6-UPMC, Paris, France; Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Spire Sciences, Boca Raton, Florida, USA; Department of Rheumatology, Slagelse Hospital, Slagelse, Denmark; Division of Rheumatology Research, Swedish Medical Center, University of Washington School of Medicine; and Seattle Rheumatology Associates, Seattle, Washington, USA; Department of Radiology, Charité University Hospital, Berlin, Germany; Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; University of California, San Francisco, and Synarc Inc., San Francisco, California, USA. M. Østergaard, MD, PhD, DMSc, Professor of Rheumatology, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital and Department of Clinical Medicine, University of Copenhagen; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip MRI, Senior Lecturer, University of NSW; F. Gandjbakhch, MD, Practicing Rheumatologist, Department of Rheumatology, Pitié-Salpêtrière, APHP, Université Paris 6-UPMC; I. Eshed, MD, Professor of Radiology, Sheba Medical Center, Tel Aviv University; I.K. Haugen, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital; E.A. Haavardsholm, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital; S. Lillegraven, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital, University of Oslo; V. Foltz, MD, Practicing Rheumatologist,
| | - Violaine Foltz
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; University of New South Wales, Sydney, Australia; Department of Rheumatology, Pitié-Salpêtrière Hospital, APHP, Université Paris 6-UPMC, Paris, France; Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Spire Sciences, Boca Raton, Florida, USA; Department of Rheumatology, Slagelse Hospital, Slagelse, Denmark; Division of Rheumatology Research, Swedish Medical Center, University of Washington School of Medicine; and Seattle Rheumatology Associates, Seattle, Washington, USA; Department of Radiology, Charité University Hospital, Berlin, Germany; Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; University of California, San Francisco, and Synarc Inc., San Francisco, California, USA. M. Østergaard, MD, PhD, DMSc, Professor of Rheumatology, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital and Department of Clinical Medicine, University of Copenhagen; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip MRI, Senior Lecturer, University of NSW; F. Gandjbakhch, MD, Practicing Rheumatologist, Department of Rheumatology, Pitié-Salpêtrière, APHP, Université Paris 6-UPMC; I. Eshed, MD, Professor of Radiology, Sheba Medical Center, Tel Aviv University; I.K. Haugen, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital; E.A. Haavardsholm, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital; S. Lillegraven, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital, University of Oslo; V. Foltz, MD, Practicing Rheumatologist,
| | - Daniel Glinatsi
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; University of New South Wales, Sydney, Australia; Department of Rheumatology, Pitié-Salpêtrière Hospital, APHP, Université Paris 6-UPMC, Paris, France; Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Spire Sciences, Boca Raton, Florida, USA; Department of Rheumatology, Slagelse Hospital, Slagelse, Denmark; Division of Rheumatology Research, Swedish Medical Center, University of Washington School of Medicine; and Seattle Rheumatology Associates, Seattle, Washington, USA; Department of Radiology, Charité University Hospital, Berlin, Germany; Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; University of California, San Francisco, and Synarc Inc., San Francisco, California, USA. M. Østergaard, MD, PhD, DMSc, Professor of Rheumatology, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital and Department of Clinical Medicine, University of Copenhagen; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip MRI, Senior Lecturer, University of NSW; F. Gandjbakhch, MD, Practicing Rheumatologist, Department of Rheumatology, Pitié-Salpêtrière, APHP, Université Paris 6-UPMC; I. Eshed, MD, Professor of Radiology, Sheba Medical Center, Tel Aviv University; I.K. Haugen, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital; E.A. Haavardsholm, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital; S. Lillegraven, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital, University of Oslo; V. Foltz, MD, Practicing Rheumatologist,
| | - Charles Peterfy
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; University of New South Wales, Sydney, Australia; Department of Rheumatology, Pitié-Salpêtrière Hospital, APHP, Université Paris 6-UPMC, Paris, France; Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Spire Sciences, Boca Raton, Florida, USA; Department of Rheumatology, Slagelse Hospital, Slagelse, Denmark; Division of Rheumatology Research, Swedish Medical Center, University of Washington School of Medicine; and Seattle Rheumatology Associates, Seattle, Washington, USA; Department of Radiology, Charité University Hospital, Berlin, Germany; Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; University of California, San Francisco, and Synarc Inc., San Francisco, California, USA. M. Østergaard, MD, PhD, DMSc, Professor of Rheumatology, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital and Department of Clinical Medicine, University of Copenhagen; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip MRI, Senior Lecturer, University of NSW; F. Gandjbakhch, MD, Practicing Rheumatologist, Department of Rheumatology, Pitié-Salpêtrière, APHP, Université Paris 6-UPMC; I. Eshed, MD, Professor of Radiology, Sheba Medical Center, Tel Aviv University; I.K. Haugen, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital; E.A. Haavardsholm, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital; S. Lillegraven, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital, University of Oslo; V. Foltz, MD, Practicing Rheumatologist,
| | - Bo Ejbjerg
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; University of New South Wales, Sydney, Australia; Department of Rheumatology, Pitié-Salpêtrière Hospital, APHP, Université Paris 6-UPMC, Paris, France; Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Spire Sciences, Boca Raton, Florida, USA; Department of Rheumatology, Slagelse Hospital, Slagelse, Denmark; Division of Rheumatology Research, Swedish Medical Center, University of Washington School of Medicine; and Seattle Rheumatology Associates, Seattle, Washington, USA; Department of Radiology, Charité University Hospital, Berlin, Germany; Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; University of California, San Francisco, and Synarc Inc., San Francisco, California, USA. M. Østergaard, MD, PhD, DMSc, Professor of Rheumatology, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital and Department of Clinical Medicine, University of Copenhagen; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip MRI, Senior Lecturer, University of NSW; F. Gandjbakhch, MD, Practicing Rheumatologist, Department of Rheumatology, Pitié-Salpêtrière, APHP, Université Paris 6-UPMC; I. Eshed, MD, Professor of Radiology, Sheba Medical Center, Tel Aviv University; I.K. Haugen, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital; E.A. Haavardsholm, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital; S. Lillegraven, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital, University of Oslo; V. Foltz, MD, Practicing Rheumatologist,
| | - Pernille Bøyesen
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; University of New South Wales, Sydney, Australia; Department of Rheumatology, Pitié-Salpêtrière Hospital, APHP, Université Paris 6-UPMC, Paris, France; Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Spire Sciences, Boca Raton, Florida, USA; Department of Rheumatology, Slagelse Hospital, Slagelse, Denmark; Division of Rheumatology Research, Swedish Medical Center, University of Washington School of Medicine; and Seattle Rheumatology Associates, Seattle, Washington, USA; Department of Radiology, Charité University Hospital, Berlin, Germany; Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; University of California, San Francisco, and Synarc Inc., San Francisco, California, USA. M. Østergaard, MD, PhD, DMSc, Professor of Rheumatology, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital and Department of Clinical Medicine, University of Copenhagen; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip MRI, Senior Lecturer, University of NSW; F. Gandjbakhch, MD, Practicing Rheumatologist, Department of Rheumatology, Pitié-Salpêtrière, APHP, Université Paris 6-UPMC; I. Eshed, MD, Professor of Radiology, Sheba Medical Center, Tel Aviv University; I.K. Haugen, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital; E.A. Haavardsholm, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital; S. Lillegraven, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital, University of Oslo; V. Foltz, MD, Practicing Rheumatologist,
| | - Philip J Mease
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; University of New South Wales, Sydney, Australia; Department of Rheumatology, Pitié-Salpêtrière Hospital, APHP, Université Paris 6-UPMC, Paris, France; Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Spire Sciences, Boca Raton, Florida, USA; Department of Rheumatology, Slagelse Hospital, Slagelse, Denmark; Division of Rheumatology Research, Swedish Medical Center, University of Washington School of Medicine; and Seattle Rheumatology Associates, Seattle, Washington, USA; Department of Radiology, Charité University Hospital, Berlin, Germany; Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; University of California, San Francisco, and Synarc Inc., San Francisco, California, USA. M. Østergaard, MD, PhD, DMSc, Professor of Rheumatology, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital and Department of Clinical Medicine, University of Copenhagen; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip MRI, Senior Lecturer, University of NSW; F. Gandjbakhch, MD, Practicing Rheumatologist, Department of Rheumatology, Pitié-Salpêtrière, APHP, Université Paris 6-UPMC; I. Eshed, MD, Professor of Radiology, Sheba Medical Center, Tel Aviv University; I.K. Haugen, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital; E.A. Haavardsholm, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital; S. Lillegraven, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital, University of Oslo; V. Foltz, MD, Practicing Rheumatologist,
| | - Kay-Geert Hermann
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; University of New South Wales, Sydney, Australia; Department of Rheumatology, Pitié-Salpêtrière Hospital, APHP, Université Paris 6-UPMC, Paris, France; Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Spire Sciences, Boca Raton, Florida, USA; Department of Rheumatology, Slagelse Hospital, Slagelse, Denmark; Division of Rheumatology Research, Swedish Medical Center, University of Washington School of Medicine; and Seattle Rheumatology Associates, Seattle, Washington, USA; Department of Radiology, Charité University Hospital, Berlin, Germany; Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; University of California, San Francisco, and Synarc Inc., San Francisco, California, USA. M. Østergaard, MD, PhD, DMSc, Professor of Rheumatology, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital and Department of Clinical Medicine, University of Copenhagen; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip MRI, Senior Lecturer, University of NSW; F. Gandjbakhch, MD, Practicing Rheumatologist, Department of Rheumatology, Pitié-Salpêtrière, APHP, Université Paris 6-UPMC; I. Eshed, MD, Professor of Radiology, Sheba Medical Center, Tel Aviv University; I.K. Haugen, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital; E.A. Haavardsholm, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital; S. Lillegraven, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital, University of Oslo; V. Foltz, MD, Practicing Rheumatologist,
| | - Paul Emery
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; University of New South Wales, Sydney, Australia; Department of Rheumatology, Pitié-Salpêtrière Hospital, APHP, Université Paris 6-UPMC, Paris, France; Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Spire Sciences, Boca Raton, Florida, USA; Department of Rheumatology, Slagelse Hospital, Slagelse, Denmark; Division of Rheumatology Research, Swedish Medical Center, University of Washington School of Medicine; and Seattle Rheumatology Associates, Seattle, Washington, USA; Department of Radiology, Charité University Hospital, Berlin, Germany; Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; University of California, San Francisco, and Synarc Inc., San Francisco, California, USA. M. Østergaard, MD, PhD, DMSc, Professor of Rheumatology, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital and Department of Clinical Medicine, University of Copenhagen; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip MRI, Senior Lecturer, University of NSW; F. Gandjbakhch, MD, Practicing Rheumatologist, Department of Rheumatology, Pitié-Salpêtrière, APHP, Université Paris 6-UPMC; I. Eshed, MD, Professor of Radiology, Sheba Medical Center, Tel Aviv University; I.K. Haugen, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital; E.A. Haavardsholm, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital; S. Lillegraven, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital, University of Oslo; V. Foltz, MD, Practicing Rheumatologist,
| | - Harry K Genant
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; University of New South Wales, Sydney, Australia; Department of Rheumatology, Pitié-Salpêtrière Hospital, APHP, Université Paris 6-UPMC, Paris, France; Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Spire Sciences, Boca Raton, Florida, USA; Department of Rheumatology, Slagelse Hospital, Slagelse, Denmark; Division of Rheumatology Research, Swedish Medical Center, University of Washington School of Medicine; and Seattle Rheumatology Associates, Seattle, Washington, USA; Department of Radiology, Charité University Hospital, Berlin, Germany; Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; University of California, San Francisco, and Synarc Inc., San Francisco, California, USA. M. Østergaard, MD, PhD, DMSc, Professor of Rheumatology, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital and Department of Clinical Medicine, University of Copenhagen; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip MRI, Senior Lecturer, University of NSW; F. Gandjbakhch, MD, Practicing Rheumatologist, Department of Rheumatology, Pitié-Salpêtrière, APHP, Université Paris 6-UPMC; I. Eshed, MD, Professor of Radiology, Sheba Medical Center, Tel Aviv University; I.K. Haugen, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital; E.A. Haavardsholm, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital; S. Lillegraven, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital, University of Oslo; V. Foltz, MD, Practicing Rheumatologist,
| | - Philip G Conaghan
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; University of New South Wales, Sydney, Australia; Department of Rheumatology, Pitié-Salpêtrière Hospital, APHP, Université Paris 6-UPMC, Paris, France; Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Spire Sciences, Boca Raton, Florida, USA; Department of Rheumatology, Slagelse Hospital, Slagelse, Denmark; Division of Rheumatology Research, Swedish Medical Center, University of Washington School of Medicine; and Seattle Rheumatology Associates, Seattle, Washington, USA; Department of Radiology, Charité University Hospital, Berlin, Germany; Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; University of California, San Francisco, and Synarc Inc., San Francisco, California, USA. M. Østergaard, MD, PhD, DMSc, Professor of Rheumatology, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital and Department of Clinical Medicine, University of Copenhagen; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip MRI, Senior Lecturer, University of NSW; F. Gandjbakhch, MD, Practicing Rheumatologist, Department of Rheumatology, Pitié-Salpêtrière, APHP, Université Paris 6-UPMC; I. Eshed, MD, Professor of Radiology, Sheba Medical Center, Tel Aviv University; I.K. Haugen, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital; E.A. Haavardsholm, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital; S. Lillegraven, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital, University of Oslo; V. Foltz, MD, Practicing Rheumatologist,
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Glinatsi D, Lillegraven S, Haavardsholm EA, Eshed I, Conaghan PG, Peterfy C, Gandjbakhch F, Bird P, Bøyesen P, Døhn UM, Genant HK, Østergaard M. Validation of the OMERACT Magnetic Resonance Imaging Joint Space Narrowing Score for the Wrist in a Multireader Longitudinal Trial. J Rheumatol 2015; 42:2480-5. [DOI: 10.3899/jrheum.141009] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objective.To assess the intrareader and interreader agreement and sensitivity to change of the Outcome Measures in Rheumatology (OMERACT) Rheumatoid Arthritis Magnetic Resonance Imaging Joint Space Narrowing (RAMRIS-JSN) score in the rheumatoid arthritis (RA) wrist in a longitudinal multireader exercise.MethodsCoronal T1-weighted MR image sets of 1 wrist from 20 patients with early RA were assessed twice for JSN at 17 sites at baseline and after 36 or 60 months by 4 readers blinded to patient data but not time order. The joints were scored 0–4 according to the OMERACT RAMRIS-JSN score. Intraclass correlation coefficients (ICC), smallest detectable change (SDC), percentage exact/close agreement (PEA/PCA), and standardized response mean (SRM) were calculated.Results.Median baseline and change score was 10.3 and 1.9, respectively. Intrareader ICC for baseline and change scores was good (≥ 0.50) to very good (≥ 0.80) for all and 3 of 4 readers, respectively. Interreader ICC was very good for change (0.93), while poor for baseline score if all 4 readers were included (0.36), but very good if 1 reader was excluded (0.87). Intrareader and interreader SDC was low (2.34–3.18), except for the intrareader SDC for 1 reader (6.75). The mean PEA/PCA was high for baseline and change scores both within and between the readers (51.5–99.2), except for interreader baseline PEA (14.4). SRM was moderate for all readers (0.55–0.77).Conclusion.The OMERACT RAMRIS-JSN score showed high overall intrareader and interreader reliability, and moderate sensitivity to change, supporting inclusion of the measure as part of the OMERACT RAMRIS system.
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Eshed I, Krabbe S, Østergaard M, Bøyesen P, Møller JM, Therkildsen F, Madsen OR, Axelsen M, Pedersen SJ. Influence of field strength, coil type and image resolution on assessment of synovitis by unenhanced MRI – a comparison with contrast-enhanced MRI. Eur Radiol 2014; 25:1059-67. [DOI: 10.1007/s00330-014-3470-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 08/14/2014] [Accepted: 10/15/2014] [Indexed: 12/15/2022]
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Visser AW, Bøyesen P, Haugen IK, Schoones JW, van der Heijde DM, Rosendaal FR, Kloppenburg M. Radiographic scoring methods in hand osteoarthritis--a systematic literature search and descriptive review. Osteoarthritis Cartilage 2014; 22:1710-23. [PMID: 25278080 DOI: 10.1016/j.joca.2014.05.026] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Revised: 04/18/2014] [Accepted: 05/30/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVE This systematic literature review aimed to evaluate the use of conventional radiography (CR) in hand osteoarthritis (OA) and to assess the metric properties of the different radiographic scoring methods. DESIGN Medical literature databases up to November 2013 were systematically reviewed for studies reporting on radiographic scoring of structural damage in hand OA. The use and metric properties of the scoring methods, including discrimination (reliability, sensitivity to change), feasibility and validity, were evaluated. RESULTS Of the 48 included studies, 10 provided data on reliability, 11 on sensitivity to change, four on feasibility and 36 on validity of radiographic scoring methods. Thirteen different scoring methods have been used in studies evaluating radiographic hand OA. The number of examined joints differed extensively and the obtained scores were analyzed in various ways. The reliability of the assessed radiographic scoring methods was good for all evaluated scoring methods, for both cross-sectional and longitudinal radiographic scoring. The responsiveness to change was similar for all evaluated scoring methods. There were no major differences in feasibility between the evaluated scoring methods, although the evidence was limited. There was limited knowledge about the validity of radiographic OA findings compared with clinical nodules and deformities, whereas there was better evidence for an association between radiographic findings and symptoms and hand function. CONCLUSIONS Several radiographic scoring methods are used in hand OA literature. To enhance comparability across studies in hand OA, consensus has to be reached on a preferred scoring method, the examined joints and the used presentation of data.
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Affiliation(s)
- A W Visser
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
| | - P Bøyesen
- Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - I K Haugen
- Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - J W Schoones
- Walaeus Library, Leiden University Medical Center, Leiden, The Netherlands
| | - D M van der Heijde
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - F R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - M Kloppenburg
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands; Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
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Ørnbjerg LM, Østergaard M, Bøyesen P, Krogh NS, Thormann A, Tarp U, Poulsen UE, Espesen J, Schlemmer A, Graudal N, Kollerup G, Jensen DV, Madsen OR, Glintborg B, Christensen T, Lindegaard H, Bøhme W, Hansen A, Andersen AR, Hetland ML. Which Factors Influence Radiographic Progression During Treatment with Tumor Necrosis Factor Inhibitors in Clinical Practice? Results from 930 Patients with Rheumatoid Arthritis in the Nationwide Danish DANBIO Registry. J Rheumatol 2014; 41:2352-60. [DOI: 10.3899/jrheum.131299] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objective.To investigate baseline characteristics associated with radiographic progression and the effect of disease activity, drug, switching, and withdrawal on radiographic progression in tumor necrosis factor (TNF) inhibitor-naive patients with rheumatoid arthritis (RA) followed for about 2 years after anti-TNF initiation in clinical practice.Methods.DANBIO-registered patients with RA who had available radiographs (anti-TNF initiation and ∼2 yrs followup) were included. Radiographs were scored, blinded to chronology with the Sharp/van der Heijde method and linked with DANBIO data. Baseline characteristics were investigated with univariate regression and significant variables included in a multivariable logistic regression analysis with ± radiographic progression [Δ total Sharp score (TSS) > 0] as dependent variable. Effect of time-averaged C-reactive protein (CRP), 28-joint Disease Activity Score with CRP (DAS28-CRP), and treatment status at followup were investigated with univariate regression analysis.Results.The study included 930 patients. They were 75% women, 79% positive for IgM-rheumatoid factor (IgM-RF), median age was 57 yrs (range 19–88), disease duration 9 yrs (1–59), DAS28-CRP 5.0 (1.4–7.8), TSS median 15 [3–45 interquartile range (IQR)] and mean 31 (SD 40). Patients started treatment with infliximab (59%), etanercept (18%), or adalimumab (23%). At followup (median 526 days, IQR 392–735), 61% were treated with the initial anti-TNF, 29% had switched TNF inhibitor, and 10% had withdrawn. Twenty-seven percent of patients had progressed radiographically. ΔTSS was median 0.0 [0.0–0.5 IQR/mean 0.6 (SD 2.4)] units/year. Higher TSS, older age, positive IgM-RF, and concomitant prednisolone at baseline were associated with radiographic progression. Time-averaged DAS28-CRP and time-averaged CRP, but not type of TNF inhibitor, were associated with radiographic progression. Patients who stopped/switched during followup progressed more than patients who continued treatment.Conclusion.High TSS, older age, IgM-RF positivity, and concomitant prednisolone were associated with radiographic progression during 2 years of followup of 930 anti-TNF–treated patients with RA in clinical practice. High disease activity and switching/stopping anti-TNF treatment were associated with radiographic progression.
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Haugen IK, Slatkowsky-Christensen B, Bøyesen P, Sesseng S, van der Heijde D, Kvien TK. MRI findings predict radiographic progression and development of erosions in hand osteoarthritis. Ann Rheum Dis 2014; 75:117-23. [PMID: 25204463 DOI: 10.1136/annrheumdis-2014-205949] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Accepted: 08/23/2014] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To examine whether MRI features predict radiographic progression including erosive evolution in patients from the Oslo hand osteoarthritis (OA) cohort, which is the first longitudinal hand OA study with available MRI. METHODS We included 74 patients (91% female, mean (SD) age of 67.9 (5.3) years) with MRI of the dominant hand and conventional radiographs taken at baseline and 5-year follow-up. Baseline MRIs were read according to the Oslo hand OA MRI score. We used three definitions of radiographic progression: Progression of joint space narrowing (JSN, grades 0-3), increased Kellgren-Lawrence score (grades 0-4) or incident erosions (absent/present). For each definition, we examined whether MRI features predicted radiographic progression in the same joint using Generalised Estimating Equations. We adjusted for age, sex, Body Mass Index, follow-up time and other erosive joints (the latter for analyses on incident erosions only). RESULTS MRI-defined moderate/severe synovitis (OR=3.52, 95% CI 1.29 to 9.59), bone marrow lesions (BML) (OR=2.73, 95% CI 1.29 to 5.78) and JSN (severe JSN: OR=11.05, 95% CI 3.22 to 37.90) at baseline predicted progression of radiographic JSN. Similar results were found for increasing Kellgren-Lawrence score, except for weaker association for JSN. Baseline synovitis, BMLs, JSN, bone damage, osteophytes and malalignment were significantly associated with development of radiographic erosions, of which malalignment showed the strongest association (OR=10.18, 95% CI 2.01 to 51.64). CONCLUSIONS BMLs, synovitis and JSN were the strongest predictors for radiographic progression. Malalignment was associated with incident erosions only. Future studies should explore whether reducing BMLs and inflammation can decrease the risk of structural progression.
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Affiliation(s)
- Ida K Haugen
- Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | | | - Pernille Bøyesen
- Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Sølve Sesseng
- Department of Radiology, Diakonhjemmet Hospital, Oslo, Norway
| | - Désirée van der Heijde
- Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Tore K Kvien
- Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
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Krabbe S, Eshed I, Pedersen SJ, Bøyesen P, Møller JM, Therkildsen F, Axelsen MB, Madsen OR, Østergaard M. Bone marrow oedema assessment by magnetic resonance imaging in rheumatoid arthritis wrist and metacarpophalangeal joints: the importance of field strength, coil type and image resolution. Rheumatology (Oxford) 2014; 53:1446-51. [PMID: 24659753 DOI: 10.1093/rheumatology/keu029] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The aim of this study was to examine the influence of different MRI unit field strengths, coil types and image resolutions on the OMERACT RA MRI scoring system (RAMRIS) of bone marrow oedema (BME) and image quality. METHODS Forty-one patients and 12 healthy controls participated in this cross-sectional study. Coronal short tau inversion recovery (STIR) and T1-weighted sequences were obtained at 0.23, 0.6, 1.5 and 3T using flex coils (Flex). Additional STIR sequences were obtained with phased array extremity coils (Extr) (at 0.6 and 1.5T) and higher resolution (at 1.5T). In otal, 338 STIR image sets were anonymized and scored according to RAMRIS and parameters of image quality were measured. RESULTS The BME sum scores were similar overall when comparing the different MRI units, coil types and voxel sizes, yet significantly higher at the higher resolution of 1.5T Extr compared with 0.23T Flex (P = 0.004), 0.6T Flex (P = 0.03), 1.5T Flex (P = 0.05) and 3T Flex (P = 0.001). Mean differences were relatively minor (0-3.5). Intrareader reliability of BME scores was high [intraclass correlation coefficient ≥ 0.90 for all except 0.23T (0.81) and percentage exact agreement 81-88%]. The smallest detectable difference was better at 0.6, 1.5 and 3T (9-29% of maximum value) than at 0.23T (40%). Image quality was lowest at 0.23T. CONCLUSION No major, consistent differences were found between BME scores using STIR sequences obtained at different field strengths, coil types and image resolutions, suggesting that these are equally suited for assessment of BME in RA. However, parameters of image quality and intrareader reliability (favouring 0.6, 1.5 and 3T) should be considered when selecting the MRI acquisition strategy.
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Affiliation(s)
- Simon Krabbe
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Copenhagen University Hospital Glostrup, Copenhagen, Denmark, Department of Radiology, Sheba Medical Center, Tel Hashomer, Israel, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, Department of Radiology, Copenhagen University Hospital Herlev, Metropolitan University College Copenhagen and Department of Rheumatology, Copenhagen University Hospital Gentofte, Copenhagen, Denmark.
| | - Iris Eshed
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Copenhagen University Hospital Glostrup, Copenhagen, Denmark, Department of Radiology, Sheba Medical Center, Tel Hashomer, Israel, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, Department of Radiology, Copenhagen University Hospital Herlev, Metropolitan University College Copenhagen and Department of Rheumatology, Copenhagen University Hospital Gentofte, Copenhagen, Denmark
| | - Susanne Juhl Pedersen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Copenhagen University Hospital Glostrup, Copenhagen, Denmark, Department of Radiology, Sheba Medical Center, Tel Hashomer, Israel, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, Department of Radiology, Copenhagen University Hospital Herlev, Metropolitan University College Copenhagen and Department of Rheumatology, Copenhagen University Hospital Gentofte, Copenhagen, Denmark
| | - Pernille Bøyesen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Copenhagen University Hospital Glostrup, Copenhagen, Denmark, Department of Radiology, Sheba Medical Center, Tel Hashomer, Israel, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, Department of Radiology, Copenhagen University Hospital Herlev, Metropolitan University College Copenhagen and Department of Rheumatology, Copenhagen University Hospital Gentofte, Copenhagen, Denmark
| | - Jakob M Møller
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Copenhagen University Hospital Glostrup, Copenhagen, Denmark, Department of Radiology, Sheba Medical Center, Tel Hashomer, Israel, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, Department of Radiology, Copenhagen University Hospital Herlev, Metropolitan University College Copenhagen and Department of Rheumatology, Copenhagen University Hospital Gentofte, Copenhagen, Denmark
| | - Flemming Therkildsen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Copenhagen University Hospital Glostrup, Copenhagen, Denmark, Department of Radiology, Sheba Medical Center, Tel Hashomer, Israel, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, Department of Radiology, Copenhagen University Hospital Herlev, Metropolitan University College Copenhagen and Department of Rheumatology, Copenhagen University Hospital Gentofte, Copenhagen, Denmark
| | - Mette Bjørndal Axelsen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Copenhagen University Hospital Glostrup, Copenhagen, Denmark, Department of Radiology, Sheba Medical Center, Tel Hashomer, Israel, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, Department of Radiology, Copenhagen University Hospital Herlev, Metropolitan University College Copenhagen and Department of Rheumatology, Copenhagen University Hospital Gentofte, Copenhagen, Denmark
| | - Ole Rintek Madsen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Copenhagen University Hospital Glostrup, Copenhagen, Denmark, Department of Radiology, Sheba Medical Center, Tel Hashomer, Israel, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, Department of Radiology, Copenhagen University Hospital Herlev, Metropolitan University College Copenhagen and Department of Rheumatology, Copenhagen University Hospital Gentofte, Copenhagen, Denmark
| | - Mikkel Østergaard
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Copenhagen University Hospital Glostrup, Copenhagen, Denmark, Department of Radiology, Sheba Medical Center, Tel Hashomer, Israel, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, Department of Radiology, Copenhagen University Hospital Herlev, Metropolitan University College Copenhagen and Department of Rheumatology, Copenhagen University Hospital Gentofte, Copenhagen, Denmark
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Kloppenburg M, Bøyesen P, Smeets W, Haugen IK, Haugen I, Liu R, Visser W, van der Heijde DM. Report from the OMERACT Hand Osteoarthritis Special Interest Group: advances and future research priorities. J Rheumatol 2014; 41:810-8. [PMID: 24429165 DOI: 10.3899/jrheum.131253] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Osteoarthritis (OA) is one of the most common musculoskeletal disorders, frequently affecting the hands. In the last decade there has been increased awareness concerning this disorder because of its clinical burden. Unfortunately, only limited treatments for symptom alleviation are available, and no effective treatment for disease modification exists. The lack of treatment is due not only to a lack of understanding of the disease process, but also to poor outcome measures to assess the condition. The OMERACT Hand OA Special Interest Group (SIG) has started to develop a core set of outcome measures for hand OA clinical trials, observational studies, and clinical record keeping. At OMERACT 11, results from a Delphi exercise were presented, and a preliminary set of core domains was discussed. The group attempted to adopt the new OMERACT Filter 2.0 in the process, and literature overviews of conventional radiographs, ultrasonography, and magnetic resonance imaging as outcome measures in hand OA were presented. Discussions that followed highlighted further suggestions for core domains, the heterogeneity of hand OA, and future research priorities.
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Affiliation(s)
- Margreet Kloppenburg
- From the Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
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Poggenborg RP, Bird P, Boonen A, Wiell C, Pedersen SJ, Sørensen IJ, Madsen OR, Slot O, Møller JM, Bøyesen P, Hasselquist M, Østergaard M. Pattern of bone erosion and bone proliferation in psoriatic arthritis hands: a high-resolution computed tomography and radiography follow-up study during adalimumab therapy. Scand J Rheumatol 2013; 43:202-8. [DOI: 10.3109/03009742.2013.835865] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Gandjbakhch F, Haavardsholm EA, Conaghan PG, Ejbjerg B, Foltz V, Brown AK, Døhn UM, Lassere M, Freeston JE, Olsen IC, Bøyesen P, Bird P, Fautrel B, Hetland ML, Emery P, Bourgeois P, Hørslev-Petersen K, Kvien TK, McQueen FM, Østergaard M. Determining a Magnetic Resonance Imaging Inflammatory Activity Acceptable State Without Subsequent Radiographic Progression in Rheumatoid Arthritis: Results from a Followup MRI Study of 254 Patients in Clinical Remission or Low Disease Activity. J Rheumatol 2013; 41:398-406. [DOI: 10.3899/jrheum.131088] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Objective.To assess the predictive value of magnetic resonance imaging (MRI)-detected subclinical inflammation for subsequent radiographic progression in a longitudinal study of patients with rheumatoid arthritis (RA) in clinical remission or low disease activity (LDA), and to determine cutoffs for an MRI inflammatory activity acceptable state in RA in which radiographic progression rarely occurs.Methods.Patients with RA in clinical remission [28-joint Disease Activity Score-C-reactive protein (DAS28-CRP) < 2.6, n = 185] or LDA state (2.6 ≤ DAS28-CRP < 3.2, n = 69) with longitudinal MRI and radiographic data were included from 5 cohorts (4 international centers). MRI were assessed according to the Outcome Measures in Rheumatology (OMERACT) RA MRI scoring system (RAMRIS). Statistical analyses included an underlying conditional logistic regression model stratified per cohort, with radiographic progression as dependent variable.Results.A total of 254 patients were included in the multivariate analyses. At baseline, synovitis was observed in 95% and osteitis in 49% of patients. Radiographic progression was observed in 60 patients (24%). RAMRIS synovitis was the only independent predictive factor in multivariate analysis. ROC analysis identified a cutoff value for baseline RAMRIS synovitis score of 5 (maximum possible score 21). Rheumatoid factor (RF) status yielded a significant interaction with synovitis (p value = 0.044). RF-positive patients with a RAMRIS synovitis score of > 5 vs ≤ 5, had an OR of 4.4 (95% CI 1.72–11.4) for radiographic progression.Conclusion.High MRI synovitis score predicts radiographic progression in patients in clinical remission/LDA. A cutoff point for determining an MRI inflammatory activity acceptable state based on the RAMRIS synovitis score was established. Incorporating MRI in future remission criteria should be considered.
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Conaghan PG, McQueen FM, Bird P, Peterfy C, Haavardsholm E, Gandjbakhch F, Eshed I, Haugen IK, Lillegraven S, Døhn UM, Ejbjerg B, Foltz V, Coates L, Bøyesen P, Hermann KG, Freeston J, Lassere M, O’Connor P, Emery P, Genant H, Østergaard M. Update on the OMERACT Magnetic Resonance Imaging Task Force: Research and Future Directions. J Rheumatol 2013; 41:383-5. [DOI: 10.3899/jrheum.131085] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Magnetic resonance imaging (MRI) provides an important biomarker across a range of rheumatological diseases. At the Outcome Measures in Rheumatology (OMERACT) 11 meeting, the MRI task force continued its work of developing and improving the use of MRI outcomes for use in clinical trials. The breadth of pathology in the Rheumatoid Arthritis MRI Score has been strengthened with further work on the development of a joint space narrowing score, and a series of exercises presented at OMERACT 11 demonstrated good reliability and construct validity for this assessment. Understanding the importance of residual inflammation after RA treatment remains a major focus of the group’s work. Analyses were presented on defining the level of synovitis (using MRI scores of a single hand) that would predict absence of erosion progression. The development of the OMERACT Hand Osteoarthritis MRI score has continued with substantial work presented on its iterative development, including pathology definition, scaling, and subsequent reliability of the score. Optimizing the role of MRI as a robust biomarker and surrogate outcome remains a priority for this group.
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Haugen IK, Østergaard M, Eshed I, McQueen FM, Bird P, Gandjbakhch F, Foltz V, Genant H, Peterfy C, Lillegraven S, Haavardsholm EA, Bøyesen P, Conaghan PG. Iterative Development and Reliability of the OMERACT Hand Osteoarthritis MRI Scoring System. J Rheumatol 2013; 41:386-91. [DOI: 10.3899/jrheum.131086] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objective.To develop and test the interreader reliability of the OMERACT Hand Osteoarthritis Magnetic Resonance Scoring System (HOAMRIS) for assessment of structural and inflammatory hand OA features in the interphalangeal joints.Methods.The HOAMRIS was developed through an iterative process. Selection of features and their scaling was agreed upon through consensus by members of the OMERACT Magnetic Resonance Imaging (MRI) Task Force, using the Oslo Hand Osteoarthritis (OA) MRI Score system as a template. Two reliability exercises were performed, in which 6 and 4 readers participated, respectively. After the first exercise, an atlas was developed and used in the second exercise to facilitate reading. In each exercise, readers independently scored 8 MRI scans from the Oslo Hand OA cohort (coronal/axial short-tau inversion recovery and coronal/axial/sagittal T1-weighted fat-suppressed pre-/post-Gadolinium images). Interreader reliability was assessed by intraclass correlation coefficients (ICC), percentage exact and close agreement (PEA/PCA).Results.The preliminary OMERACT HOAMRIS included assessment of synovitis, erosive damage, cysts, osteophytes, cartilage space loss, malalignment, and bone marrow lesions (BML), of which all were scored on a 0–3 scale for normal, mild, moderate, and severe (increments of 0.5 for synovitis, erosive damage, and BML). In the first exercise, most features showed good to very good ICC values (0.64–0.94), except synovitis (0.34). In the second exercise using the atlas, the ICC values were > 0.74 for all MRI features, and the PEA/PCA values were higher than in the first exercise.Conclusion.A preliminary HOAMRIS with good to very good interreader reliability was developed. Longitudinal studies are needed to assess its sensitivity to change.
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Haugen IK, Slatkowsky-Christensen B, Bøyesen P, van der Heijde D, Kvien TK. Cross-sectional and longitudinal associations between radiographic features and measures of pain and physical function in hand osteoarthritis. Osteoarthritis Cartilage 2013; 21:1191-8. [PMID: 23973130 DOI: 10.1016/j.joca.2013.04.004] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Revised: 03/11/2013] [Accepted: 04/09/2013] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Previous longitudinal studies have shown no associations between increasing amount of radiographic hand osteoarthritis (OA) and levels of hand pain/disability. In this longitudinal study, we aimed to study whether radiographic hand OA was related to pain/disability in cross-sectional and longitudinal settings focusing on joint-specific analyses. METHODS We included 190 patients (173 women, mean (standard deviation, SD) age 61.5 (5.7) years) from the Oslo hand OA cohort, of whom 112 had 7-year follow-up data. Finger joints were scored for radiographic OA according to the Kellgren-Lawrence scale and Osteoarthritis Research Society International (OARSI) atlas. Pain and function were assessed by clinical examination (joint tenderness), grip strength and the Australian/Canadian (AUSCAN) questionnaire. Associations between radiographic hand OA and tenderness in the same joint were examined by logistic regression analyses with Generalized Estimating Equations, whereas associations between overall amount of radiographic OA and hand pain/disability were assessed by linear regression (adjusted for age and sex). RESULTS A dose-dependent association was found between the severity of radiographic OA and tenderness in the same joint. Joints that progressed into severe radiographic OA during follow-up had the highest odds of developing tenderness (OR = 11, 95% confidence interval (CI) 4.0-33). Incident erosions seemed to be the most important individual feature associated with incident tenderness (OR = 6.2, 95% CI 3.2-12). Weak associations were found between the amount of radiographic hand OA and overall hand pain/disability. CONCLUSION Radiographic hand OA is associated with tenderness in the same joint, and erosive development strongly predicts future joint tenderness independent of other radiographic features.
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Affiliation(s)
- I K Haugen
- Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
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Poggenborg R, Wiell C, Pedersen S, Sørensen I, Madsen O, Slot O, Bøyesen P, Østergaard M. AB0946 Anti-TNF treated psoriatic arthritis: Course of composite disease activity measures and clinical core domains:. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Haugen I, Slatkowsky-Christensen B, Bøyesen P, van der Heijde D, Kvien T. FRI0312 The cross-sectional and longitudinal associations between radiographic features and joint tenderness in hand osteoarthritis:. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Haugen I, Bøyesen P, Slatkowsky-Christensen B, Sesseng S, van der Heijde D, Kvien T. THU0425 Associations between radiographic and clinical osteoarthritis features and MRI-defined bone marrow lesions in the finger joints:. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Poggenborg R, Bøyesen P, Wiell C, Pedersen S, Sørensen I, Madsen O, Slot O, Møller J, Boesen M, Bliddal H, Kubassova O, Østergaard M. AB1294 Psoriatic arthritis - a follow-up study applying dynamic MRI, conventional MRI and clinical measures:. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Haavardsholm E, Gandjbakhch F, Conaghan P, Ejbjerg B, Foltz V, Brown A, Døhn U, Lassere M, Freeston J, Bøyesen P, Bird P, Fautrel B, Hetland M, Emery P, Bourgeois P, Hørslev-Petersen K, Olsen I, Østergaard M. OP0274 Towards imaging remission: Determining a MRI inflammatory activity acceptable state in rheumatoid arthritis:. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1957] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Møller Døhn U, Conaghan PG, Eshed I, Boonen A, Bøyesen P, Peterfy C, Lillegraven S, Ejbjerg B, Gandjbakhch F, Bird P, Foltz V, Genant H, Haavaardsholm E, Mcqueen F, Østergaard M. OP0014 The Omeract-Ramris Rheumatoid Arthritis Magnetic Resonance Imaging Joint Space Narrowing Score (RAMRIS JSN) is Reproducible and Correlates Closely with Computed Tomography Assessment. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Eshed I, Krabbe S, Østergaard M, Bøyesen P, Møller J, Therkildsen F, Madsen O, Juhl Pedersen S. THU0426 Is contrast material needed for the mri scoring of synovitis of the hand in patients with rheumatoid arthritis? A systematic comparison of 0.23, 0.6, 1.5 and 3.0 tesla MRI. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Møller Døhn U, Conaghan P, Eshed I, Boonen A, Bøyesen P, Gandjbakhch F, Lillegraven S, Bird P, Foltz V, Peterfy C, Genant H, Haavardsholm E, Mcqueen F, Østergaard M. AB1307 Intra- and interreader reliability of the omeract joint space narrowing score on magnetic resonance imaging and computed tomography in rheumatoid arthritis wrist and metacarpophalangeal joints. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Conaghan PG, McQueen FM, Bird P, Peterfy CG, Haavardsholm EA, Gandjbakhch F, Bøyesen P, Coates L, Ejbjerg B, Eshed I, Foltz V, Hermann KG, Freeston J, Lillegraven S, Lassere M, Wiell C, Anandarajah A, Duer-Jensen A, O'Connor P, Genant HK, Emery P, Ostergaard M. Update on research and future directions of the OMERACT MRI inflammatory arthritis group. J Rheumatol 2012; 38:2031-3. [PMID: 21885512 DOI: 10.3899/jrheum.110419] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The OMERACT Magnetic Resonance Imaging (MRI) Task Force has developed and evolved the psoriatic arthritis MRI score (PsAMRIS) over the last few years, and at OMERACT 10, presented longitudinal evaluation by multiple readers, using PsA datasets obtained from extremity MRI magnets. Further evaluation of this score will require more PsA imaging datasets. As well, due to improved image resolution since the development of the original rheumatoid arthritis MRI scoring system (RAMRIS), the Task Force has worked on semiquantitative assessment of joint space narrowing, and developed a reliable method as a potential RAMRIS addendum, although responsiveness will need to be evaluated. One of the strengths of MRI is the ability to detect subclinical synovitis, so the group worked on obtaining low disease activity/clinical remission datasets from a number of international centers and presented cross-sectional findings. Subsequent longitudinal evaluation of this unique resource will be a major continuing focus for the group.
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Affiliation(s)
- Philip G Conaghan
- Department of Rheumatology, Pitié Salpetrière Hospital, APHP, Université Paris 6-UPMC, Paris, France.
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Ørnbjerg LM, Østergaard M, Bøyesen P, Krogh NS, Thormann A, Tarp U, Poulsen UE, Espesen J, Ringsdal VS, Graudal N, Kollerup G, Jensen DV, Madsen OR, Glintborg B, Christensen T, Lindegaard H, Dencker D, Hansen A, Andersen AR, Hetland ML. Impact of tumour necrosis factor inhibitor treatment on radiographic progression in rheumatoid arthritis patients in clinical practice: results from the nationwide Danish DANBIO registry. Ann Rheum Dis 2012; 72:57-63. [DOI: 10.1136/annrheumdis-2012-201319] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Mathiessen A, Haugen IK, Slatkowsky-Christensen B, Bøyesen P, Kvien TK, Hammer HB. Ultrasonographic assessment of osteophytes in 127 patients with hand osteoarthritis: exploring reliability and associations with MRI, radiographs and clinical joint findings. Ann Rheum Dis 2012; 72:51-6. [DOI: 10.1136/annrheumdis-2011-201195] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Haugen IK, Bøyesen P. Imaging modalities in hand osteoarthritis--and perspectives of conventional radiography, magnetic resonance imaging, and ultrasonography. Arthritis Res Ther 2011; 13:248. [PMID: 22189142 PMCID: PMC3334630 DOI: 10.1186/ar3509] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Hand osteoarthritis (OA) is very frequent in middle-aged and older women and men in the general population. Currently, owing to high feasibility and low costs, conventional radiography (CR) is the method of choice for evaluation of hand OA. CR provides a two-dimensional picture of bony changes, such as osteophytes, erosions, cysts, and sclerosis, and joint space narrowing as an indirect measure of cartilage loss. There are several standardized scoring methods for evaluation of radiographic hand OA. The scales have shown similar reliability, validity, and sensitivity to change, and no conclusion about the preferred instrument has been drawn. Patients with hand OA may experience pain, stiffness, and physical disability, but the associations between radiographic findings and clinical symptoms are weak to moderate and vary across studies. OA is, indeed, recognized to involve the whole joint, and modern imaging techniques such as ultrasound (US) and magnetic resonance imaging (MRI) could be valuable tools for better evaluation of hand OA. Standardized scoring methods have been proposed for both modalities. Several studies have examined the validity of US features in hand OA, whereas knowledge of the validity of MRI is more limited. However, both synovitis (detected by either US or MRI) and MRI-defined bone marrow lesions have been associated with pain, indicating that treatment of inflammation is important for pain management in hand OA. Both US and MRI have shown better sensitivity than CR in detection of erosions, and this may indicate that erosive hand OA may be more common than previously thought.
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Affiliation(s)
- Ida K Haugen
- Department of Rheumatology, Diakonhjemmet Hospital, P,O, Box 23, Vinderen, 0319 Oslo, Norway.
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Haugen IK, Bøyesen P, Slatkowsky-Christensen B, Sesseng S, van der Heijde D, Kvien TK. Associations between MRI-defined synovitis, bone marrow lesions and structural features and measures of pain and physical function in hand osteoarthritis. Ann Rheum Dis 2011; 71:899-904. [DOI: 10.1136/annrheumdis-2011-200341] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Haugen IK, Bøyesen P, Slatkowsky-Christensen B, Sesseng S, Bijsterbosch J, van der Heijde D, Kvien TK. Comparison of features by MRI and radiographs of the interphalangeal finger joints in patients with hand osteoarthritis. Ann Rheum Dis 2011; 71:345-50. [DOI: 10.1136/annrheumdis-2011-200028] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
ObjectivesTo examine the construct validity of MRI in the detection of structural hand osteoarthritis features with conventional radiography (CR) as reference and explore the association between radiographic severity and MRI-defined pathology.Methods106 hand osteoarthritis patients (97 women, mean age 68.9 years (SD 5.6)) had 1.0T contrast-enhanced MRI and CR of the dominant hand. The 2nd–5th interphalangeal joints were scored according to the preliminary Oslo hand osteoarthritis MRI score and Kellgren–Lawrence (KL) scale and Osteoarthritis Research Society International atlas for radiographs. The authors compared the number of joints with structural features by MRI and CR (Wilcoxon signed-rank test) and examined concordance at the individual joint level. The OR of MRI features in joints with doubtful (KL grade 1), mild (2) and moderate/severe (≥3) radiographic osteoarthritis was estimated by generalised estimating equations (KL grade 0 as reference).ResultsMRI detected approximately twice as many joints with erosions and osteophytes compared with CR (p<0.001), but identification of joint space narrowing, cysts and malalignment was similar. The sensitivity of MRI was very high for osteophytes (1.00) and erosions (0.95), while specificity was lower (0.22 and 0.63). The prevalence of most MRI features increased with radiographic severity, but synovitis was more frequent in joints with mild osteoarthritis (OR2.1, 95% CI 1.4 to 3.2) than in moderate/severe osteoarthritis (OR1.4, 95% CI 1.0 to 2.2).ConclusionMRI detected more osteophytes and erosions than CR, suggesting that erosive osteoarthritis may be more common than indicated by CR. Synovitis was most common in mild osteoarthritis. Whether this is due to burn-out of inflammation in late disease must be investigated further.
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Ostergaard M, Bøyesen P, Eshed I, Gandjbakhch F, Lillegraven S, Bird P, Foltz V, Boonen A, Lassere M, Hermann KG, Anandarajah A, Døhn UM, Freeston J, Peterfy CG, Genant HK, Haavardsholm EA, McQueen FM, Conaghan PG. Development and preliminary validation of a magnetic resonance imaging joint space narrowing score for use in rheumatoid arthritis: potential adjunct to the OMERACT RA MRI scoring system. J Rheumatol 2011; 38:2045-50. [PMID: 21885515 DOI: 10.3899/jrheum.110422] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To develop and validate a magnetic resonance imaging (MRI) method of assessment of joint space narrowing (JSN) in rheumatoid arthritis (RA). METHODS Phase A: JSN was scored 0-4 on MR images of 5 RA patients and 3 controls at 15 wrist sites and 2nd-5th metacarpophalangeal (MCP) joints by 8 readers (7 once, one twice), using a preliminary scoring system. Phase B: Image review, discussion, and consensus on JSN definition, and revised scoring system. Phase C: MR images of 15 RA patients and 4 controls were scored using revised system by 5 readers (4 once, one twice), and results compared with radiographs [Sharp-van der Heijde (SvdH) method]. RESULTS Phase A: Intraobserver agreement: intraclass correlation coefficient (ICC) = 0.99; smallest detectable difference (SDD, for mean of readings) = 2.8 JSN units (4.9% of observed maximal score). Interobserver agreement: ICC = 0.93; SDD = 6.4 JSN units (9.9%). Phase B: Agreement was reached on JSN definition (reduced joint space width compared to normal, as assessed in a slice perpendicular to the joint surface), and revised scoring system (0-4 at 17 wrist sites and 2nd-5th MCP; 0: none; 1: 1-33%; 2: 34-66%; 3: 67-99%; 4: ankylosis). Phase C: Intraobserver agreement: ICC = 0.90; SDD = 6.8 JSN units (11.0%). Interobserver agreement: ICC = 0.92 and SDD = 6.2 JSN units (8.7%). The correlation (ICC) with the SvdH radiographic JSN score of the wrist/hand was 0.77. Simplified approaches evaluating fewer joint spaces demonstrated similar reliability and correlation with radiographic scores. CONCLUSION An MRI scoring system of JSN in RA wrist and MCP joints was developed and showed construct validity and good intra- and interreader agreements. The system may, after further validation in longitudinal data sets, be useful as an outcome measure in RA.
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Affiliation(s)
- Mikkel Ostergaard
- Department of Rheumatology, Copenhagen University Hospital at Glostrup, Copenhagen, Denmark.
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Vis M, Haavardsholm EA, Bøyesen P, Haugeberg G, Uhlig T, Hoff M, Woolf A, Dijkmans B, Lems W, Kvien TK. High incidence of vertebral and non-vertebral fractures in the OSTRA cohort study: a 5-year follow-up study in postmenopausal women with rheumatoid arthritis. Osteoporos Int 2011; 22:2413-9. [PMID: 21229234 PMCID: PMC3150654 DOI: 10.1007/s00198-010-1517-6] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2009] [Accepted: 09/29/2010] [Indexed: 11/24/2022]
Abstract
UNLABELLED A 5-year follow-up study was performed in female RA patients with established disease looking at vertebral fractures, scored on spinal X-rays, and non-vertebral fractures. We found a high incidence rate of vertebral and non-vertebral fractures in these patients compared to population-based studies. INTRODUCTION The aim of this study is to investigate the incidence of vertebral and non-vertebral fractures over a 5-year period in a cohort of postmenopausal patients with established rheumatoid arthritis (RA). METHODS One hundred and fifty female patients with established RA were included into the OSTRA cohort. The cohort was assessed at baseline and at 5 years for incident vertebral and non-vertebral fractures. Spinal X-rays were taken at baseline and at follow-up and scored using the semi-quantitative method according to Genant. RESULTS At 5 years, 102 patients (68%) were examined and included in the present analysis. At baseline, the mean age was 61 years, disease duration 17 years, body mass index 25.5 kg/m(2) and 65% of the patients were rheumatoid factor positive. Fifteen percent were treated with bisphosphonates, 25% received calcium supplementation and 20% vitamin-D supplementation at baseline. During the 5-year follow-up, a total of 16 patients out of 102 patients (16%) had a new non-vertebral fracture [annual incidence of 3.2 (95% CI 1.8-5.5) per 100 patients/year]. In 18 patients out of 97 patients (19%), new vertebral fractures were identified on spinal X-ray [annual incidence of 3.7 (95% C.I. 2.2-5.8) per 100 patients/year]. CONCLUSIONS We found a high incidence of vertebral and non-vertebral fractures in a cohort of women with established RA compared to population-based studies.
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Affiliation(s)
- M Vis
- Department of Rheumatology and Jan van Breemen Institute, VU University medical center, Postbus 7057, 1007MB, Amsterdam, The Netherlands.
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Haugen IK, Lillegraven S, Slatkowsky-Christensen B, Haavardsholm EA, Sesseng S, Kvien TK, van der Heijde D, Bøyesen P. Hand osteoarthritis and MRI: development and first validation step of the proposed Oslo Hand Osteoarthritis MRI score. Ann Rheum Dis 2011; 70:1033-8. [DOI: 10.1136/ard.2010.144527] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
ObjectivesMRI scoring systems for hand osteoarthritis (HOA) are currently not available. The present work proposes the Oslo HOA MRI (OHOA-MRI) score and examines the intrareader and inter-reader reliability.MethodsRelevant HOA features were included in the initial version of the OHOA-MRI score after literature review and informal group discussions. After a training session and two calibration exercises (with three readers), features with low reliability and/or low prevalence were excluded, and feature definitions/gradings were improved. In the reliability exercise 3 readers independently evaluated MRI scans of distal interphalangeal (DIP) and proximal interphalangeal (PIP) joints in 10 patients with HOA according to the final proposed score. The reading was repeated after 1 week. Intraclass correlation coefficients (ICCs), percentage exact agreement/percentage close agreement (PEA/PCA) and smallest detectable difference were calculated.ResultsThe final proposed OHOA-MRI score includes assessment of synovitis, flexor tenosynovitis, erosions, osteophytes (OPs), joint space narrowing (JSN) and bone marrow lesions (BMLs) on a 0–3 scale, and absence/presence of cysts, malalignment (frontal/sagittal plane), collateral ligaments (CLs) and BMLs at CL insertion sites. Inter-reader reliability was very good for synovitis, erosions, OPs, JSN, malalignment (frontal) and BMLs (ICCs ≥0.83, PCA ≥89%), and good for flexor tenosynovitis (ICC 0.64, PCA 80%) and CL presence (ICC 0.79, PEA 63%). Cysts, malalignment (sagittal) and BMLs at CL insertion sites showed high PEA (≥85%), but poor to moderate ICCs (0.00–0.59). Intrareader reliability was similar. The reliability was generally highest in PIP joints.ConclusionsThe proposed OHOA-MRI score could reliably assess HOA features. However, further validation is needed.
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Bøyesen P, Haavardsholm EA, van der Heijde D, Østergaard M, Hammer HB, Sesseng S, Kvien TK. Prediction of MRI erosive progression: a comparison of modern imaging modalities in early rheumatoid arthritis patients. Ann Rheum Dis 2010; 70:176-9. [PMID: 21068093 DOI: 10.1136/ard.2009.126953] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To examine the associations between modern imaging modalities and joint damage measured as 1-year MRI erosive progression, in early rheumatoid arthritis (RA) patients. METHODS 84 RA patients with disease duration of less than 1 year were included in this inception cohort. Patients were evaluated at baseline, 3, 6 and 12 months by core measures of disease activity, MRI and ultrasound grey-scale (USGS) of inflammation, conventional radiography and digital x-ray radiogrammetry (DXR) bone mineral density (BMD) of cortical hand bone. RESULTS 53 of the 79 patients (67%) who completed the follow-up had MRI erosive progression (dependent variable). USGS and MRI bone marrow oedema (BME) were in multivariate analyses independent predictors of 1-year MRI erosive progression. There was a trend towards higher MRI synovitis score and 3-month DXR BMD loss in patients developing MRI erosions. On an individual level, USGS inflammation, MRI synovitis and MRI BME also somewhat better predicted outcome than rheumatoid factor, anticitrullinated protein antibodies and disease activity score 28. CONCLUSIONS USGS inflammation and MRI BME were independent predictors of MRI erosive progression in early RA patients on a group level. The exact prognosis of the individual patients could not be determined by imaging alone.
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Affiliation(s)
- Pernille Bøyesen
- Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
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