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Diagnostic Accuracy of Candidate Magnetic Resonance Imaging Knee Osteoarthritis Definitions Versus Radiograph in an Acute Anterior Cruciate Ligament Injury Cohort

Liew, Jean W. ; Turkiewicz, Aleksandra LU ; Roemer, Frank W. LU ; Frobell, Richard B. LU ; Felson, David and Englund, Martin LU orcid (2023) In Arthritis Care and Research
Abstract

Objective: We tested the diagnostic accuracy of previously proposed magnetic resonance imaging (MRI) osteoarthritis (OA) definitions in a cohort after acute anterior cruciate ligament (ACL) injury. Methods: We studied participants with posteroanterior and lateral knee radiographs and MRI 5 years after ACL injury, scored using the Anterior Cruciate Ligament Osteoarthritis Score. Radiographic OA (ROA) was defined using Osteoarthritis Research Society International scoring of osteophytes and joint space narrowing considering medial/lateral tibiofemoral and patellofemoral compartments. We tested three candidate MRI OA definitions that performed well in an older adult cohort. “Multicenter Osteoarthritis Study (MOST) simple” required... (More)

Objective: We tested the diagnostic accuracy of previously proposed magnetic resonance imaging (MRI) osteoarthritis (OA) definitions in a cohort after acute anterior cruciate ligament (ACL) injury. Methods: We studied participants with posteroanterior and lateral knee radiographs and MRI 5 years after ACL injury, scored using the Anterior Cruciate Ligament Osteoarthritis Score. Radiographic OA (ROA) was defined using Osteoarthritis Research Society International scoring of osteophytes and joint space narrowing considering medial/lateral tibiofemoral and patellofemoral compartments. We tested three candidate MRI OA definitions that performed well in an older adult cohort. “Multicenter Osteoarthritis Study (MOST) simple” required cartilage score ≥2 (range 0–6) and osteophyte score ≥2 (0–7); “MOST optional” included cartilage score ≥2, osteophyte score ≥2, and either bone marrow lesions (BMLs) ≥1 (0–3) or synovitis ≥2 (0–3). The third, a Delphi panel definition, included nonzero scores for cartilage, osteophyte, BMLs, meniscus, and other structures. We calculated sensitivity and specificity with 95% confidence intervals (95% CIs) for each MRI definition versus ROA. Results: We included 113 participants (mean age 26 years, 26% female). At 5 years, 29 participants (26%) had ROA. “MOST simple” had a sensitivity of 52% (95% CI 33%–71%), and specificity of 76% (95% CI 66%–85%). Sensitivity and specificities for “MOST optional” were 28% (95% CI 29%–67%) and 83% (95% CI 74%–91%), respectively. The Delphi panel definition had a sensitivity of 48% (95% CI 29%–67%) and specificity of 77% (95% CI 67%–86%). Conclusion: Simple MRI-based OA definitions requiring at least cartilage damage and an osteophyte have low sensitivity and high specificity in young persons after knee injury.

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; ; ; ; and
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Contribution to journal
publication status
epub
subject
in
Arthritis Care and Research
publisher
John Wiley & Sons Inc.
external identifiers
  • pmid:37781746
  • scopus:85179944105
ISSN
2151-464X
DOI
10.1002/acr.25248
language
English
LU publication?
yes
id
338c1058-19cc-4d15-907a-9ca5ed60d526
date added to LUP
2024-01-09 15:37:10
date last changed
2024-04-24 11:32:10
@article{338c1058-19cc-4d15-907a-9ca5ed60d526,
  abstract     = {{<p>Objective: We tested the diagnostic accuracy of previously proposed magnetic resonance imaging (MRI) osteoarthritis (OA) definitions in a cohort after acute anterior cruciate ligament (ACL) injury. Methods: We studied participants with posteroanterior and lateral knee radiographs and MRI 5 years after ACL injury, scored using the Anterior Cruciate Ligament Osteoarthritis Score. Radiographic OA (ROA) was defined using Osteoarthritis Research Society International scoring of osteophytes and joint space narrowing considering medial/lateral tibiofemoral and patellofemoral compartments. We tested three candidate MRI OA definitions that performed well in an older adult cohort. “Multicenter Osteoarthritis Study (MOST) simple” required cartilage score ≥2 (range 0–6) and osteophyte score ≥2 (0–7); “MOST optional” included cartilage score ≥2, osteophyte score ≥2, and either bone marrow lesions (BMLs) ≥1 (0–3) or synovitis ≥2 (0–3). The third, a Delphi panel definition, included nonzero scores for cartilage, osteophyte, BMLs, meniscus, and other structures. We calculated sensitivity and specificity with 95% confidence intervals (95% CIs) for each MRI definition versus ROA. Results: We included 113 participants (mean age 26 years, 26% female). At 5 years, 29 participants (26%) had ROA. “MOST simple” had a sensitivity of 52% (95% CI 33%–71%), and specificity of 76% (95% CI 66%–85%). Sensitivity and specificities for “MOST optional” were 28% (95% CI 29%–67%) and 83% (95% CI 74%–91%), respectively. The Delphi panel definition had a sensitivity of 48% (95% CI 29%–67%) and specificity of 77% (95% CI 67%–86%). Conclusion: Simple MRI-based OA definitions requiring at least cartilage damage and an osteophyte have low sensitivity and high specificity in young persons after knee injury.</p>}},
  author       = {{Liew, Jean W. and Turkiewicz, Aleksandra and Roemer, Frank W. and Frobell, Richard B. and Felson, David and Englund, Martin}},
  issn         = {{2151-464X}},
  language     = {{eng}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{Arthritis Care and Research}},
  title        = {{Diagnostic Accuracy of Candidate Magnetic Resonance Imaging Knee Osteoarthritis Definitions Versus Radiograph in an Acute Anterior Cruciate Ligament Injury Cohort}},
  url          = {{http://dx.doi.org/10.1002/acr.25248}},
  doi          = {{10.1002/acr.25248}},
  year         = {{2023}},
}