From the Departments of Rheumatology and Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research, Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; Department of Rheumatology, Pitié Salpêtriere Hospital, APHP, Université Pierre et Marie Curie, Paris, France; Spire Sciences Inc., Boca Raton, Florida, USA; Department of Diagnostic Imaging, Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel; Departments of Radiology and Medicine, University of California San Francisco, San Francisco, California, USA; Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
F.P. Kroon, MD, Department of Rheumatology, Leiden University Medical Center; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and National Institute for Health Research, Leeds Musculoskeletal Biomedical Research Unit; V. Foltz, MD, Practicing Rheumatologist, Department of Rheumatology, Pitié Salpêtriere Hospital, APHP, Université Pierre et Marie Curie; F. Gandjbakhch, MD, Practicing Rheumatologist; Department of Rheumatology, Pitié Salpêtriere Hospital, APHP, Université Pierre et Marie Curie; C. Peterfy, MD, PhD, FRCP, Chief Executive Officer, Spire Sciences Inc.; I. Eshed, MD, Associate Professor of Radiology, Department of Diagnostic Imaging, Sheba Medical Center, Tel Aviv University; H.K. Genant, MD, FACR, FRCR, Professor Emeritus of Radiology, Medicine and Orthopedics, Departments of Radiology and Medicine, University of California San Francisco; 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; M. Kloppenburg, MD, PhD, Professor of Rheumatology, Departments of Rheumatology and Clinical Epidemiology, Leiden University Medical Center; I.K. Haugen, MD, PhD, Postdoctoral Researcher; Department of Rheumatology, Diakonhjemmet Hospital.
J Rheumatol. 2017 Nov;44(11):1694-1698. doi: 10.3899/jrheum.161099. Epub 2017 Mar 1.
To develop the Outcome Measures in Rheumatology (OMERACT) thumb base osteoarthritis (OA) magnetic resonance imaging (MRI) scoring system (TOMS) for the assessment of inflammatory and structural abnormalities in this hand OA subset, and test its cross-sectional reliability.
Included features and their scaling were agreed upon by members of the OMERACT MRI Task Force using the Hand OA MRI scoring system as a template. A reliability exercise was performed in which 3 readers participated, using a preliminary atlas with examples to facilitate reading. Each reader independently scored a set of 20 MRI (coronal and axial T1- and T2-weighted fat-suppressed images, of which 5 included T1-weighted fat-suppressed post-Gadolinium images). Intra- and inter-reader reliability were assessed using ICC, percentage exact agreement (PEA), and percentage close agreement (PCA).
The TOMS assessed the first carpometacarpal (CMC-1) and scaphotrapeziotrapezoid (STT) joints for synovitis, subchondral bone defects (including erosions, cysts, and bone attrition), osteophytes, cartilage, and bone marrow lesions on a 0-3 scale (normal to severe). Subluxation was evaluated only in the CMC-1 joint (absent/present). Reliability of scoring for both joints was comparable. Interreader ICC were good for all features (0.77-0.99 and 0.74-0.96 for CMC-1 and STT joints, respectively). Intrareader reliability analyses gave similar results. PCA was ≥ 65% for all features. PEA was low to moderate, with better performance for subchondral bone defects, subluxation, and bone marrow lesions.
A thumb base OA MRI scoring system has been developed. The OMERACT TOMS demonstrated good intrareader and interreader reliability. Longitudinal studies are warranted to investigate reliability of change scores and responsiveness.
制定用于评估手部关节炎亚组炎症和结构异常的 OMERACT 拇指基底关节炎（OA）磁共振成像（MRI）评分系统（TOMS），并测试其横断面可靠性。
使用 HAND OA MRI 评分系统作为模板，通过 OMERACT MRI 工作组的成员达成纳入特征及其评分标准。进行了一项可靠性研究，其中 3 名读者参与，使用初步图谱和示例来方便阅读。每位读者独立对一组 20 份 MRI（冠状面和矢状面 T1 和 T2 加权脂肪抑制图像，其中 5 份包括 T1 加权脂肪抑制后钆增强图像）进行评分。使用 ICC、完全一致百分比（PEA）和接近一致百分比（PCA）评估读者内和读者间的可靠性。
TOMS 对第一掌腕（CMC-1）和舟状骨大多角骨（STT）关节进行滑膜炎、软骨下骨缺损（包括侵蚀、囊肿和骨磨损）、骨赘、软骨和骨髓病变评估，评分范围为 0-3 级（从正常到严重）。半脱位仅在 CMC-1 关节中评估（存在/不存在）。两个关节的评分可靠性相当。两种关节的所有特征的读者间 ICC 均良好（CMC-1 和 STT 关节分别为 0.77-0.99 和 0.74-0.96）。读者内可靠性分析得出了类似的结果。PCA 对于所有特征均≥65%。PEA 较低至中等，对于软骨下骨缺损、半脱位和骨髓病变的表现较好。
制定了拇指基底 OA MRI 评分系统。OMERACT TOMS 显示出良好的读者内和读者间可靠性。需要进行纵向研究来调查变化评分的可靠性和反应性。
