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A modification of the Omeract RA MRI score for erosions for use with an extremity MRI system with reduced field of view
  1. Jane E Freeston1,
  2. Ewa Olech2,
  3. David Yocum3,
  4. Elizabeth M A Hensor1,
  5. Paul Emery1,
  6. Philip G Conaghan1
  1. 1
    Academic Unit of Musculoskeletal Disease, Chapel Allerton Hospital, Chapeltown Road, Leeds, UK
  2. 2
    University of Oklahoma Medical Research Foundation, Oklahoma City, OK, USA
  3. 3
    Stanford University, Palo Alto, CA, USA
  1. Professor Philip Conaghan, Academic Unit of Musculoskeletal Disease, Chapel Allerton Hospital, Chapeltown Road, Leeds LS7 4SA, UK; p.conaghan{at}leeds.ac.uk

Abstract

Objectives: To develop and test the reliability of a modified version of the OMERACT rheumatoid arthritis magnetic resonance imaging score (RAMRIS) for erosions using extremity MRI (eMRI) with reduced field of view (RAMRIS-RV).

Methods: Using a MagneVu 0.2 T machine, the preliminary RAMRIS-RV assessed erosions in metacarpophalangeal (MCP) joints 2–3, bases of metacarpal (MC) 2–5, and all wrist bones excluding base MC 1, pisiform and trapezium. T1 weighted images of ⩾500 MCP and wrist bony sites from a mixed severity RA and control cohort were evaluated. An inter-reader reliability study evaluating 300 wrist and 160 MCP bony sites was then performed.

Results: Mean per cent exact (and close) agreement results were as follows: MCP proximal sites 83.5 (96.2), MCP distal 54.4 (77.2), bases MC 2–4 85.2 (96.7), carpal bones 79.0 (92.1), distal radius/ulna 66.4 (87.8). The base of MCP 5 was visualised in ⩽50% cases (13/25) and was removed from the final RAMRIS-RV.

Conclusions: The RAMRIS-RV is a practical tool that can be used with eMRI with a reduced field of view. This study shows excellent inter-reader reliability for erosion assessment, albeit in a reduced number of bony sites.

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Footnotes

  • The MagneVu machine was funded through a grant-in-aid from Centocor, USA and was not donated by the manufacturer. Centocor (especially Rebecca Bolce and Greg Keenan) also supported JF’s work by an unrestricted grant.

  • Competing interests: None declared.

  • Abbreviations:
    eMRI
    extremity magnetic resonance imaging
    FOV
    field of view
    MC
    metacarpal
    MCP
    metacarpophalangeal
    MRI
    magnetic resonance imaging
    OMERACT
    Outcome Measures in RA Clinical Trials
    RA
    rheumatoid arthritis
    RAMRIS
    rheumatoid arthritis magnetic resonance imaging score
    RAMRIS-RV
    rheumatoid arthritis magnetic resonance imaging score for extremity MRI with reduced field of view

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