Summary
Objective
To explore the diagnostic performance of routine magnetic resonance imaging (MRI)
for the cross-sectional assessment of osteophytes (OPs) in all three knee compartments
using computed tomography (CT) as a reference standard.
Methods
The Strontium Ranelate Efficacy in Knee Osteoarthritis (SEKOIA) trial explored the
effect of 3 years of treatment with strontium ranelate in patients with primary knee
OA. OPs were scored for the baseline visit only using a modified MRI Osteoarthritis
Knee Score (MOAKS) scoring system in the patellofemoral (PFJ), the medial tibiofemoral
(TFJ) and the lateral TFJ. Size was assessed from 0 to 3 in 18 locations. Descriptive
statistics were used to describe differences in ordinal grading between CT and MRI.
In addition, weighted-kappa statistics were employed to assess agreement between scoring
using the two methods. Sensitivity, specificity, positive predictive value and negative
predictive value as well as area under the curve (AUC) measures of diagnostic performance
were employed using CT as the reference standard.
Results
Included were 74 patients with available MRI and CT data. Mean age was 62.9 ± 7.5
years. Altogether 1,332 locations were evaluated. For the PFJ, MRI detected 141 (72%)
of 197 CT-defined OPs with a w-kappa of 0.58 (95% CI [0.52–0.65]). In the medial TFJ,
MRI detected 178 (81%) of 219 CT-OPs with a w-kappa of 0.58 (95% CI [0.51–0.64]).
For the lateral compartment these numbers were 84 (70%) of 120 CT-OPs with a w-kappa
of 0.58 (95% CI [0.50–0.66]).
Conclusion
MRI underestimates presence of osteophytes in all three knee compartments. CT may
be helpful particularly regarding assessment of small osteophytes particularly in
early disease.
Keywords
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References
- Radiological assessment of osteo-arthrosis.Ann Rheum Dis. 1957; 16: 494-502
- Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association.Arthritis Rheum. 1986; 29: 1039-1049
- The prevalence of knee osteoarthritis in the elderly. The Framingham Osteoarthritis Study.Arthritis Rheum. 1987; 30: 914-918
- Atlas of individual radiographic features in osteoarthritis, revised.Osteoarthritis Cartilage. 2007; 15 (A1-56)
- Comparison of meniscal extrusion and osteophyte formation at the intercondylar notch as a predictive biomarker for incidence of knee osteoarthritis-Data from the Osteoarthritis Initiative.J Orthop Sci. 2019; 24: 121-127
- Association of pain with radiological changes in different compartments and views of the knee joint.Osteoarthritis Cartilage. 1996; 4: 143-147
- Associations of anatomical measures from MRI with radiographically defined knee osteoarthritis score, pain, and physical functioning.J Bone Joint Surg Am. 2011; 93: 241-251
- Osteophytes: relevance and biology.Osteoarthritis Cartilage. 2007; 15: 237-244
- The changing role of TGFbeta in healthy, ageing and osteoarthritic joints.Nat Rev Rheumatol. 2017; 13: 155-163
- Crucial role of synovial lining macrophages in the promotion of transforming growth factor beta-mediated osteophyte formation.Arthritis Rheum. 2004; 50: 103-111
- Characterisation of size and direction of osteophyte in knee osteoarthritis: a radiographic study.Ann Rheum Dis. 2002; 61: 319-324
- OARSI Clinical Trials Recommendations: knee imaging in clinical trials in osteoarthritis.Osteoarthritis Cartilage. 2015; 23: 698-715
- Heterogeneity of cartilage damage in Kellgren and Lawrence grade 2 and 3 knees: the MOST study.Osteoarthritis Cartilage. 2022; 30: 714-723
- Influence of variation in semiflexed knee positioning during image acquisition on separate quantitative radiographic parameters of osteoarthritis, measured by Knee Images Digital Analysis.Osteoarthritis Cartilage. 2012; 20: 997-1003
- The role of radiography and MRI for eligibility assessment in DMOAD trials of knee OA.Nat Rev Rheumatol. 2018; 14: 372-380
- Three-dimensional CAIPIRINHA SPACE TSE for 5-minute high-resolution MRI of the knee.Invest Radiol. 2016; 51: 609-617
- Simultaneous multislice accelerated turbo spin echo magnetic resonance imaging: comparison and combination with in-plane parallel imaging acceleration for high-resolution magnetic resonance imaging of the knee.Invest Radiol. 2017; 52: 529-537
- MRI-based screening for structural definition of eligibility in clinical DMOAD trials: Rapid OsteoArthritis MRI Eligibility Score (ROAMES).Osteoarthritis Cartilage. 2020; 28: 71-81
- Whole-organ magnetic resonance imaging score (WORMS) of the knee in osteoarthritis.Osteoarthritis Cartilage. 2004; 12: 177-190
- Evolution of semi-quantitative whole joint assessment of knee OA: MOAKS (MRI Osteoarthritis Knee Score).Osteoarthritis Cartilage. 2011; 19: 990-1002
- Short tau inversion recovery and proton density-weighted fat suppressed sequences for the evaluation of osteoarthritis of the knee with a 1.0 T dedicated extremity MRI: development of a time-efficient sequence protocol.Eur Radiol. 2005; 15: 978-987
- The osteoarthritis initiative: report on the design rationale for the magnetic resonance imaging protocol for the knee.Osteoarthritis Cartilage. 2008; 16: 1433-1441
- Diagnostic performance of 3D standing CT imaging for detection of knee osteoarthritis features.Phys Sportsmed. 2015; 43: 213-220
- CT arthrography, MR arthrography, PET, and scintigraphy in osteoarthritis.Radiol Clin North Am. 2009; 47: 595-615
- Proximal tibial osteophyte volumes are correlated spatially and with knee alignment: a quantitative analysis suggesting the influence of biochemical and mechanical factors in the development of osteophytes.Osteoarthritis Cartilage. 2021; 29: 1691-1700
- Clinically meaningful effect of strontium ranelate on symptoms in knee osteoarthritis: a responder analysis.Rheumatology. 2014; 53: 1457-1464
- Disease-modifying effect of strontium ranelate in a subset of patients from the Phase III knee osteoarthritis study SEKOIA using quantitative MRI: reduction in bone marrow lesions protects against cartilage loss.Ann Rheum Dis. 2015; 74: 422-429
- Efficacy and safety of strontium ranelate in the treatment of knee osteoarthritis: results of a double-blind, randomised placebo-controlled trial.Ann Rheum Dis. 2013; 72: 179-186
- Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee.J Rheumatol. 1988; 15: 1833-1840
- Bone marrow lesions identified by MRI in knee osteoarthritis are associated with locally increased bone mineral density measured by QCT.Osteoarthritis Cartilage. 2013; 21: 957-964
- A 2-year randomised, double-blind, placebo-controlled, multicentre study of oral selective iNOS inhibitor, cindunistat (SD-6010), in patients with symptomatic osteoarthritis of the knee.Ann Rheum Dis. 2013; 72: 187-195
- Effects of doxycycline on progression of osteoarthritis: results of a randomized, placebo-controlled, double-blind trial.Arthritis Rheum. 2005; 52: 2015-2025
- Lorecivivint, a novel intraarticular CDC-like kinase 2 and dual-specificity tyrosine phosphorylation-regulated kinase 1A inhibitor and Wnt pathway modulator for the treatment of knee osteoarthritis: a phase II randomized trial.Arthritis Rheumatol. 2020; 72: 1694-1706
- Reduction of osteophyte formation and synovial thickening by adenoviral overexpression of transforming growth factor beta/bone morphogenetic protein inhibitors during experimental osteoarthritis.Arthritis Rheum. 2003; 48: 3442-3451
- Development of periarticular osteophytes in experimentally induced osteoarthritis in the dog. A study using microradiographic, microangiographic, and fluorescent bone-labelling techniques.Ann Rheum Dis. 1975; 34: 12-25
- Correlation between radiographically diagnosed osteophytes and magnetic resonance detected cartilage defects in the tibiofemoral joint.Ann Rheum Dis. 1998; 57: 401-407
- Prevalence of magnetic resonance imaging-defined atrophic and hypertrophic phenotypes of knee osteoarthritis in a population-based cohort.Arthritis Rheum. 2012; 64: 429-437
- Are structural abnormalities on knee MRI associated with osteophyte development? Data from the Osteoarthritis Initiative.Osteoarthritis Cartilage. 2021; 29: 1701-1708
- 7-Tesla MRI evaluation of the knee, 25 years after cartilage repair surgery: the influence of intralesional osteophytes on biochemical quality of cartilage.Cartilage. 2021; 13: 767S-779S
- Machine-learning, MRI bone shape and important clinical outcomes in osteoarthritis: data from the Osteoarthritis Initiative.Ann Rheum Dis. 2021; 80: 502-508
- OA phenotypes, rather than disease stage, drive structural progression--identification of structural progressors from 2 phase III randomized clinical studies with symptomatic knee OA.Osteoarthritis Cartilage. 2015; 23: 550-558
- Knee osteoarthritis phenotypes and their relevance for outcomes: a systematic review.Osteoarthritis Cartilage. 2017; 25: 1926-1941
- Comparison of tibiofemoral joint space width measurements from standing CT and fixed flexion radiography.J Orthop Res. 2017; 35: 1388-1395
- Quantitative three-dimensional assessment of knee joint space width from weight-bearing CT.Radiology. 2021; 299: 649-659
- Quantitative knee arthrography in a large animal model of osteoarthritis using photon-counting detector CT.Invest Radiol. 2020; 55: 349-356
- Qualitative and quantitative ultrashort-TE MRI of cortical bone.NMR Biomed. 2013; 26: 489-506
- Qualitative and quantitative ultrashort echo time imaging of musculoskeletal tissues.Semin Musculoskelet Radiol. 2015; 19: 375-386
- Feasibility of using an inversion-recovery ultrashort echo time (UTE) sequence for quantification of glenoid bone loss.Skeletal Radiol. 2018; 47: 973-980
- Ultrashort time-to-echo magnetic resonance imaging at 3 T for the detection of spondylolysis in cadaveric spines: comparison with CT.Invest Radiol. 2019; 54: 32-38
- State of the art: imaging of osteoarthritis-revisited 2020.Radiology. 2020; 296: 5-21
Article info
Publication history
Published online: February 14, 2023
Accepted:
January 31,
2023
Received:
August 12,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
