MRI scoring of osteoarthritis of the ankle

Aboelmagd, Sharief (2016) MRI scoring of osteoarthritis of the ankle. Doctoral thesis, University of East Anglia.

[thumbnail of 2016AboelmagdPhD.pdf]
Download (3MB) | Preview


The aim of this project was to develop a semi-quantitative MRI based scoring system for osteoarthritis of the ankle, and determine its inter and intraobserver reliability.
A systematic search was performed to identify current MRI scoring systems and review the methods and included features of these systems. Based on this, a Delphi survey of a group of experts was undertaken to determine the features
to be taken forward for reliability testing.
A retrospective sample of 50 patients who had undergone MRI and plain radiographs were included. Anatomical division of the ankle was based on existing published systems. MR examinations were graded using the proposed system by two consultant radiologists and two radiology trainees. Radiographs were graded using a published Kellgren-Lawrence ankle score. Inter and intraobserver reliability were examined using a weighted kappa statistic (kw), and association between MRI and radiographic severity using Spearman’s Rho.
Inter-reader reliability was “almost perfect” for all features for total joint scores (kw 0.88–0.97) except osteophyte scoring for the trainees that was “substantial” (kappa 0.64). Zonal based assessment of features demonstrated “substantial” agreement between the trainees (kw 0.63–0.75), and “substantial” or “almost perfect” agreement for the consultants (kw 0.73–0.92). Inter-reader reliability was “almost perfect” for surface extent of cartilage loss across all readers. Intrareader
reproducibility was "substantial" or "almost perfect" for total joint scores and “moderate” to “almost perfect” for the zonal approach. There was strong positive correlation between all features and radiographic severity (rho 0.75–0.85) except cysts which demonstrated “weak” correlation (rho 0.35).
This new grading system demonstrates “substantial” to “almost perfect” inter and intra-observer reproducibility and may be of use in longitudinal studies
Further research and development will include assessment of validity and sensitivity to change.

Item Type: Thesis (Doctoral)
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: Users 2593 not found.
Date Deposited: 29 Nov 2017 10:35
Last Modified: 29 Nov 2017 10:35


Downloads per month over past year

Actions (login required)

View Item View Item