Can we have an overall osteoarthritis severity score for the patellofemoral joint using magnetic resonance imaging? Reliability and validity

Journal article


Kobayashi, Sarah, Peduto, Anthony, Simic, Milena, Fransen, Marlene, Refshauge, Kathryn, Mah, Jean and Pappas, Evangelos. (2018). Can we have an overall osteoarthritis severity score for the patellofemoral joint using magnetic resonance imaging? Reliability and validity. Clinical Rheumatology. 37(4), pp. 1091-1098. https://doi.org/10.1007/s10067-017-3888-y
AuthorsKobayashi, Sarah, Peduto, Anthony, Simic, Milena, Fransen, Marlene, Refshauge, Kathryn, Mah, Jean and Pappas, Evangelos
Abstract

This work aimed to assess inter-rater reliability and agreement of a magnetic resonance imaging (MRI)-based Kellgren and Lawrence (K&L) grading for patellofemoral joint osteoarthritis (OA) and to validate it against the MRI Osteoarthritis Knee Score (MOAKS). MRI scans from people aged 45 to 75 years with chronic knee pain participating in a randomised clinical trial evaluating dietary supplements were utilised. Fifty participants were randomly selected and scored using the MRI-based K&L grading using axial and sagittal MRI scans. Raters conducted inter-rater reliability, blinded to clinical information, radiology reports and other rater results. Intra- and inter-rater reliability and agreement were evaluated using the intra-class correlation coefficient (ICC) and Cohen’s weighted kappa. There was a 2-week interval between the first and second readings for intra-rater reliability. Validity was assessed using the MOAKS and evaluated using Spearman’s correlation coefficient. Intra-rater reliability of the K&L system was excellent: ICC 0.91 (95% CI 0.82–0.95); weighted kappa (ĸ = 0.69). Inter-rater reliability was high (ICC 0.88; 95% CI 0.79–0.93), while agreement between raters was moderate (ĸ = 0.49–0.57). Validity analysis demonstrated a strong correlation between the total MOAKS features score and the K&L grading system (ρ = 0.62–0.67) but weak correlations when compared with individual MOAKS features (ρ = 0.19–0.61). The high reliability and good agreement show consistency in grading the severity of patellofemoral OA with the MRI-based K&L score. Our validity results suggest that the scale may be useful, particularly in the clinical environment. Future research should validate this method against clinical findings.

Keywordsbone; cartilage; diagnostic imaging; knee; magnetic resonance imaging; osteoarthritis
Year2018
JournalClinical Rheumatology
Journal citation37 (4), pp. 1091-1098
PublisherSpringer
ISSN0770-3198
Digital Object Identifier (DOI)https://doi.org/10.1007/s10067-017-3888-y
Scopus EID2-s2.0-85033462159
Research or scholarlyResearch
Page range1091-1098
FunderNational Health and Medical Research Council
Department of Health and Ageing, Australian Government
Sanofi-Aventis Consumer Healthcare
Publisher's version
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All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
Online06 Nov 2017
Publication process dates
Accepted23 Oct 2017
Deposited19 Aug 2022
Grant ID402511
402781
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