The reliability of a novel magnetic resonance imaging-based tool for the evaluation of forefoot bursae in patients with rheumatoid arthritis: the FFB score

Lindsey Cherry; Leonard King; Matthew Thomas; Frank Roemer; David Culliford; Catherine J Bowen; Nigel K Arden; Christopher J Edwards

doi:10.1093/rheumatology/keu232

The reliability of a novel magnetic resonance imaging-based tool for the evaluation of forefoot bursae in patients with rheumatoid arthritis: the FFB score

Rheumatology (Oxford). 2014 Nov;53(11):2014-7. doi: 10.1093/rheumatology/keu232. Epub 2014 Jun 6.

Authors

Lindsey Cherry¹, Leonard King², Matthew Thomas², Frank Roemer³, David Culliford³, Catherine J Bowen³, Nigel K Arden³, Christopher J Edwards³

Affiliations

¹ Faculty of Health Sciences, University of Southampton, Department of Podiatry, Solent NHS Trust, Department of Radiology, University Hospital Southampton NHS Foundation Trust, Southampton, UK, Department of Radiology, Klinikum Augsburg, Augsburg, Germany, Department of Radiology, Boston University, Boston, MA, USA, Faculty of Medicine, University of Southampton, Southampton, Nuffield Department of Orthopaedics and Rheumatology, University of Oxford, Oxford and NIHR-Wellcome Trust Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Southampton, UK. Faculty of Health Sciences, University of Southampton, Department of Podiatry, Solent NHS Trust, Department of Radiology, University Hospital Southampton NHS Foundation Trust, Southampton, UK, Department of Radiology, Klinikum Augsburg, Augsburg, Germany, Department of Radiology, Boston University, Boston, MA, USA, Faculty of Medicine, University of Southampton, Southampton, Nuffield Department of Orthopaedics and Rheumatology, University of Oxford, Oxford and NIHR-Wellcome Trust Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Southampton, UK. l.cherry@soton.ac.uk.
² Faculty of Health Sciences, University of Southampton, Department of Podiatry, Solent NHS Trust, Department of Radiology, University Hospital Southampton NHS Foundation Trust, Southampton, UK, Department of Radiology, Klinikum Augsburg, Augsburg, Germany, Department of Radiology, Boston University, Boston, MA, USA, Faculty of Medicine, University of Southampton, Southampton, Nuffield Department of Orthopaedics and Rheumatology, University of Oxford, Oxford and NIHR-Wellcome Trust Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
³ Faculty of Health Sciences, University of Southampton, Department of Podiatry, Solent NHS Trust, Department of Radiology, University Hospital Southampton NHS Foundation Trust, Southampton, UK, Department of Radiology, Klinikum Augsburg, Augsburg, Germany, Department of Radiology, Boston University, Boston, MA, USA, Faculty of Medicine, University of Southampton, Southampton, Nuffield Department of Orthopaedics and Rheumatology, University of Oxford, Oxford and NIHR-Wellcome Trust Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Southampton, UK. Faculty of Health Sciences, University of Southampton, Department of Podiatry, Solent NHS Trust, Department of Radiology, University Hospital Southampton NHS Foundation Trust, Southampton, UK, Department of Radiology, Klinikum Augsburg, Augsburg, Germany, Department of Radiology, Boston University, Boston, MA, USA, Faculty of Medicine, University of Southampton, Southampton, Nuffield Department of Orthopaedics and Rheumatology, University of Oxford, Oxford and NIHR-Wellcome Trust Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Southampton, UK.

Abstract

Objective: The aim of this study was to determine the reliability of an MRI-based score that evaluates forefoot bursae (FFBs) in patients with RA.

Methods: Items for inclusion, grading criteria and MRI sequences were determined iteratively. The score was evaluated in 30 patients with established RA. Reader agreement was evaluated using the percentage of exact/close agreement, Bland-Altman plots, kappa and intraclass correlation coefficient analyses.

Results: The FFB score assesses nine forefoot regions and contains four items: presence, shape, enhancement and magnetic resonance characteristics. The FFB score showed moderate to good intra- and interreader agreement (κ range = 0.5-0.9 and 0.47-0.87, respectively).

Conclusion: The FFB score is adequately reliable in the evaluation of bursa-like lesions of the forefoot in patients with RA.

Keywords: disease activity; foot; inflammation; magnetic resonance imaging; outcome measures; radiology; rheumatoid arthritis; synovium.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Aged
Aged, 80 and over
Arthritis, Rheumatoid / diagnosis*
Bursa, Synovial / pathology*
Cross-Sectional Studies
Disease Progression
Female
Follow-Up Studies
Forefoot, Human / pathology*
Humans
Magnetic Resonance Imaging / methods*
Male
Middle Aged
Reproducibility of Results
Severity of Illness Index
Young Adult

Grants and funding

CAT-CL-03-2012-015/DH_/Department of Health/United Kingdom