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MRI-based semiquantitative scoring of joint pathology in osteoarthritis
Ali Guermazi, Frank W.Roemer, Ida K.Haugen, Michel D.Crema and Daichi Hayashi
Abstract | The use of MRI techniques to investigate tissue pathology has become increasingly widespread in osteoarthritis (OA) research. Semiquantitative assessment of the joints by expert interpreters of MRI data is a powerful tool that can increase our understanding of the natural history of this complex disease. Several reliable and validated semiquantitative scoring systems now exist and have been applied to largescale, multicentre, crosssectional and longitudinal observational epidemiological studies. Such approaches have advanced our understanding of the associations of different tissue pathologies with pain and improved the definition of joint alterations that lead to disease progression. Semiquantitative MRI outcome measures have also been applied in several clinical trials in OA. Indeed, interest in MRIbased semiquantitative scoring systems has led to the development of several novel scoring systems that can be applied to different joints: a knee synovitis scoring system based on contrastenhanced MRI; the MRI Osteoarthritis Knee Score (MOAKS); the Hip Osteoarthritis MRI Score (HOAMS); and the Oslo Hand Osteoarthritis MRI score (OHOAMRI). Although these new scoring systems offer theoretical advantages over preexisting systems, whether they offer actual superiority with regard to reliability, responsiveness and validity remains to be seen.
Guermazi, A. etal. Nat. Rev. Rheumatol. 9, 236251 (2013); published online 15 January 2013; http://www.nature.com/doifinder/10.1038/nrrheum.2012.223
Web End =doi:10.1038/nrrheum.2012.223
Introduction
The use of MRI has become increasingly common for evaluation of joint pathology in osteoarthritis (OA) research.15 The high cost of MRI and the high prevalence of OArelated features detected using MRI in people without clinical symptoms or radiographic abnormali ties associated with this disease prevent routine applica tion of this technique in the daily clinical management of patients with OA.6,7 In research, however, MRI plays a critical part by enabling investigators to visualize many OAassociated pathological features that are not detectable on conventional radiographs. For example, jointspace width, measured radiographic ally, is con sidered a surrogate indicator of the thickness of hyaline cartilage, but research incorporating MRI has revealed that jointspace narrowing reflects not only cartilage thinning, but also degeneration and change in the posi tion of the menisci.8 Bonemarrowoedemalike lesions (often called bone marrow lesions; BMLs) and synovi tis, features that are only...