Radiographic Scoring Methods Research Articles

Radiographic scores as a predictor of oxygenation index in very low-birthweight infants.

Very low birthweight infants (VLBWIs) often undergo chest radiographic examinations without standardization or objectivity. This study aimed to assess the association of two radiographic scores, the Brixia and radiographic assessment of lung edema (RALE), with oxygenation index (OI) in ventilated VLBWIs and to determine the optimal cutoff values to predict hypoxic respiratory severity. VLBWIs who received invasive respiratory support with arterial lines between January 2010 and October 2023 were enrolled in this study (n = 144). The correlation between the Brixia or RALE scores and OI was investigated. Receiver operating characteristic curve analysis was performed to determine the optimal cutoff points of the two radiographic scores for predicting OI values (OI ≥5, ≥10, and ≥15). The enrolled infants had a median gestational age of 27 weeks (interquartile range [IQR], 25-28 weeks) and a median birthweight of 855 g (IQR, 684-1003 g). Radiographic scoring methods correlated with the OI (Brixia score: r = 0.79, p < 0.001; RALE score: r = 0.72, p < 0.001). The optimal cutoff points for predicting OI values were as follows: Brixia score: OI ≥5, 10; OI ≥10, 13; OI ≥15, 15; RALE score: OI ≥5, 22; OI ≥10, 31; and OI ≥15, 40. Brixia and RALE scores are useful predictive markers of the oxygenation status in intubated VLBWIs with stable hemodynamics. These scores are easy to use and promising tools for clinicians to identify patients with a higher risk of hypoxic respiratory failure.

We Challenged the Kellgren and Lawrence Radiographic Scoring Method and Came Up With Some Interesting Epidemiology for Osteoarthritis of the Hip.

The study of hip osteoarthritis (OA) was slowed due to a lack of a good definition of radiographic hip OA (RHOA). The radiographic changes that occur in hip OA include both joint space narrowing and femoral head osteophytes in the early stages of the disease. This differs from OA of the knee, in which radiographic OA changes initially include osteophytes and only much later is joint space narrowing considered. The modified Croft Score is a novel scoring method for the hip that includes an equal weighting of femoral osteophytes and joint space narrowing. It is used to evaluate the epidemiology of prevalent, incident, and progressive RHOA. Use of the Croft Score found that mild changes in the femoral head or acetabulum could increase the risk of incident RHOA. Pioneering research on active shape modeling was undertaken to provide a more comprehensive assessment of hip shape and define actual femoral head shapes that increased the risk of RHOA. After defining RHOA, investigators found several risk factors, which included higher total hip bone mineral density and polymorphisms of the wnt/β-catenin signaling pathway, to be significant predictors of RHOA in elderly white women. Recently, it was found that RHOA was a strong risk factor for both all-cause mortality and cardiovascular disease mortality in elderly women.

Development of a radiographic scoring system for new bone formation in gout

BackgroundFeatures of new bone formation (NBF) are common in tophaceous gout. The aim of this project was to develop a plain radiographic scoring system for NBF in gout.MethodsInformed by a literature review, scoring systems were tested in 80 individual 1st and 5th metatarsophalangeal joints. Plain radiography scores were compared with computed tomography (CT) measurements of the same joints. The best-performing scoring system was then tested in paired sets of hand and foot radiographs obtained over 2 years from an additional 25 patients. Inter-reader reproducibility was assessed using intraclass correlation coefficients (ICC). NBF scores were correlated with plain radiographic erosion scores (using the gout-modified Sharp-van der Heijde system).ResultsFollowing a series of structured reviews of plain radiographs and scoring exercises, a semi-quantitative scoring system for sclerosis and spur was developed. In the individual joint analysis, the inter-observer ICC (95% CI) was 0.84 (0.76–0.89) for sclerosis and 0.81 (0.72–0.87) for spur. Plain radiographic sclerosis and spur scores correlated with CT measurements (r = 0.65–0.74, P < 0.001 for all analyses). For the hand and foot radiograph sets, the inter-observer ICC (95% CI) was 0.94 (0.90–0.98) for sclerosis score and 0.76 (0.65–0.84) for spur score. Sclerosis and spur scores correlated highly with plain radiographic erosion scores (r = 0.87 and 0.71 respectively), but not with change in erosion scores over 2 years (r = −0.04–0.15).ConclusionA semi-quantitative plain radiographic scoring method for the assessment of NBF in gout is feasible, valid, and reproducible. This method may facilitate consistent measurement of NBF in gout.

Neonatal respiratory status predicts longitudinal respiratory health outcomes in preterm infants.

To examine the relationship between neonatal respiratory status and longitudinal respiratory health outcomes in preterm infants with very low birth weight (VLBW, birth weight <1500 g). A total of 109 VLBW preterm infants were prospectively assessed for respiratory status using the Toce clinical and radiographic scoring method on a postnatal day 28, and severity of bronchopulmonary dysplasia (BPD) at 36-weeks postmenstrual age (PMA), respiratory morbidity within 1 year of corrected age (CA), pulmonary function test, and six-minute walk test at 4 years of age. A high Toce clinical score on day 28 was associated with the occurrence of respiratory morbidity within 1 year of CA and poor pulmonary function and functional exercise performance at 4 years of age in VLBW preterm infants (all P < 0.05). BPD at 36-weeks PMA was associated with an increased risk of respiratory morbidity within 1 year of CA and its negative impact on pulmonary function and functional exercise performance at 4 years of age was most pronounced in the severe form (all P < 0.05). Early assessments of neonatal respiratory status including Toce clinical score and the severity of BPD are valid to identify VLBW preterm infants who are at risk of adverse longitudinal respiratory health outcomes.

Radiographic scoring methods in rheumatoid arthritis and psoriatic arthritis.

Structural changes of bone and cartilage are the hallmarks of rheumatoid arthritis (RA) and psoriatic arthritis (PsA). Radiography can help in making diagnosis and in differentiating PsA and RA from other articular diseases. Radiography is still considered the preferred imaging method to assess disease progression, reflecting cumulative damage over time. The presence of bone erosions in RA is as an indicator of irreversible articular damage. Radiographic features of PsA are characteristic and differ from those observed in RA, especially in the distribution of affected joints and in the presence of destructive changes and bone proliferation at the same time. Semiquantitative scoring methods are designed to measure the degree of radiographically detectable joint damage and of changes over time. Several radiographic scoring methods that had been developed originally for RA have been adopted for the use in PsA. This review discusses the use of conventional radiography for diagnosing and detecting early structural changes in RA and PsA and providing a historical overview of commonly used scoring methods.

Harmonising measures of knee and hip osteoarthritis in population-based cohort studies: an international study

Population-based osteoarthritis (OA) cohorts provide vital data on risk factors and outcomes of OA, however the methods to define OA vary between cohorts. We aimed to provide recommendations for combining knee and hip OA data in extant and future population cohort studies, in order to facilitate informative individual participant level analyses. International OA experts met to make recommendations on: 1) defining OA by X-ray and/or pain; 2) compare The National Health and Nutrition Examination Survey (NHANES)-type OA pain questions; 3) the comparability of the Western Ontario & McMaster Universities Osteoarthritis Index (WOMAC) scale to NHANES-type OA pain questions; 4) the best radiographic scoring method; 5) the usefulness of other OA outcome measures. Key issues were explored using new analyses in two population-based OA cohorts (Multicenter Osteoarthritis Study; MOST and Osteoarthritis Initiative OAI). OA should be defined by both symptoms and radiographs, with symptoms alone as a secondary definition. Kellgren and Lawrence (K/L) grade ≥2 should be used to define radiographic OA (ROA). The variable wording of pain questions can result in varying prevalence between 41.0% and 75.4%, however questions where the time anchor is similar have high sensitivity and specificity (91.2% and 89.9% respectively). A threshold of 3 on a 0-20 scale (95% CI 2.1, 3.9) in the WOMAC pain subscale demonstrated equivalence with the preferred NHANES-type question. This research provides recommendations, based on expert agreement, for harmonising and combining OA data in existing and future population-based cohorts.

Increased arterial stiffness in rheumatoid arthritis and Its relation to disease activity: A cross sectional study.

BackgroundRheumatoid arthritis (RA) is associated with elevated plasma level of inflammatory markers. Chronic inflammation is known to predispose to endothelial dysfunction and increased arterial stiffness, which is an important marker of subclinical atherosclerosis and increased cardiovascular risk.ObjectiveThe aim is to test for the relationship between disease activity and arterial stiffness in RA patients.MethodsThe study included 90 RA patients, at different grades of disease activity and 45 healthy subjects, as a control group. Patients were subjected to full history taking and clinical examination, laboratory investigations including serum lipid profile and high sensitivity CRP (hs-CRP) measurements and plain x-rays of hands and feet. Modified Larsen method was used as radiographic scoring method. Disease activity score (DAS 28) was used for assessment of disease activity. Transthoracic echocardiography was performed to detect aortic stiffness parameters. Duplex ultrasound imaging of both common carotid arteries was performed to measure carotid stiffness parameters.ResultsThe mean age of RA patients was 39.86 ± 9.39 years and most of them (83.3%) were females. RA patients had higher carotid stiffness index compared to control group patients (8.57 ± 4.83 vs 4.08 ± 1.13, p < .001). Very poor correlation was found between DAS-28 and aortic (r = 0.1, p = .28) as well as carotid (r = 0.05, p = .7) stiffness indices. No statistically significant correlation was found between hs-CRP and aortic stiffness index (r = 0.64, p = .55). Disease duration was significantly correlated to intima-media thickness (p < .01) as well as with other carotid stiffness parameters. Age also show a statistically significant positive correlation with carotid stiffness parameters.ConclusionRA is associated with increased arterial stiffness, a well-recognized marker of cardiovascular risk. This is attributed to the inflammatory nature of the disease. It seems that the most important factors determining stiffness are patients' age and duration of illness.

Fully automated joint space width measurement and digital X-ray radiogrammetry in early RA

ObjectivesTo study fully automated digital joint space width (JSW) and bone mineral density (BMD) in relation to a conventional radiographic scoring method in early rheumatoid arthritis (eRA).MethodsRadiographs scored by the...

Comparation Aspect of Scoring Indexes betweens Osteoarticular Scores, Sharp’s Radiographic Indexes in Patients with Rheumathoid Arthritis Patients

Introduction: There are numerous radiographic scoring methods in Rheumathoid Arthritis (RA). The scoring method Sharp/van der Heijde (SHS) is considered “a gold standard” for the assessment of the disease progression in RA. It is reliable but complex scoring method, which is time consuming and is used by well trained readers. The simple erosion narrowing score (SENS) was derived from the SHS method as an easier, quicker and reliable method for joint lesions scoring. Aim: The aim of the present work was to use and evaluate the SENS method, for the first time in Macedonia, in comparison with SHS, and to test the agreement between the readers for the two scoring methods, in a group of patients with established RA. Materials and methods: Evaluation of the patients included collection of demographic and clinical data, physical examination and calculation of the 28-joint disease activity score, (DAS-28). Laboratory tests and bilateral radiographs of the hands, wrists and feet were done in each of the patients. The radiographs were scored in pairs by two independent readers: rheumatologist and experienced radiologist. Results: The study group consisted of 54 RA patients. The mean age of the patients was 54.4 years. The average duration of the disease was 4.74 years with the mean DAS 28 score 5.0.The average radiography scores read by the rheumatologist and radiologist were 43.7 vs.38.4 with the total SENS and 70 vs. 72 for the total SHS method. The interobserver reliability, calculated by the intraclass correlation coefficient (ICC) was 0.77 for SENS and 0.88 for SHS score. Conclusion: The performances of SENS method were good and the reading was very fast and easy. The agreement between the readers was higher for the more detailed SHS score.

Report from the OMERACT Hand Osteoarthritis Working Group: Set of Core Domains and Preliminary Set of Instruments for Use in Clinical Trials and Observational Studies.

During OMERACT 12, a workshop was held with the aim to endorse a core set of domains for 3 settings: clinical trials of symptom and structure modification and observational studies. Additional goals were to endorse a core set of contextual factors for these settings, and to define preliminary instruments for each core domain. Finally, an agenda for future research in hand osteoarthritis (OA) was to be proposed. Literature reviews of preliminary instruments for each core domain of the proposed core set for hand OA in the settings described above. Literature review of radiographic scoring methods and modern imaging in hand OA were also performed. Proposed contextual factors for a core set were identified through 2 Delphi exercises with participation of hand OA experts, patient partners, and OMERACT participants. Results from Delphi exercises and systematic literature reviews were presented and discussed. It was agreed that a preliminary core domain set for the setting clinical trials of symptom modification should contain at least "pain, physical function, patient global assessment, joint activity and hand strength." The settings clinical trial of structure modification and observational studies would in addition include structural damage. Preliminary instruments for the proposed domains were agreed on. A list of prioritized contextual factors was defined and endorsed for further research. A research agenda was proposed for domain instrument validation according to the OMERACT Filter 2.0. Preliminary core sets for clinical trials of symptom and structure modification and observational studies in hand osteoarthritis, including preliminary instruments and contextual factors, were agreed upon during OMERACT 12.

A Comparison of Two Radiography Scoring Methods Used by Rheumatologists and Radiologists in Patients with Established Rheumatoid Arthritis

Background : There are numerous radiographic scoring methods in rheumatoid arthritis (RA). The scoring method Sharp/van der Heijde (SHS) is considered “a gold standard” for the assessment of the disease progression in RA. It is reliable but complex scoring method, which is time consuming and is used by well trained readers. The Simple Erosion Narrowing Score (SENS) was derived from the SHS method as an easier, quicker and reliable method for joint lesions scoring. Aim : The aim of the present work is to use and to evaluate the SENS method, for the first time in Macedonia, in comparison with SHS, and to test the agreement between the readers for the two scoring methods, in a group of patients with established RA. Materials and Methods : Evaluation of the patients included collection of demographic and clinical data, physical examination and calculation of the 28-joint Disease Activity Score (DAS-28). Laboratory tests and bilateral radiographs of the hands, wrists and feet were done in each of the patients. The radiographs were scored in pairs by two independent readers: rheumatologist and experienced radiologist. Results : The study group consisted of 54 RA patients. The mean age of the patients was 54,4 years. The average duration of the disease was 4,74 years with the mean DAS 28 score 5,0. The average radiography scores read by the rheumatologist and radiologist were 43,7 vs. 38,6 for the total SENS and 70 vs. 72 for the total SHS score. The interobserver reliability was calculated by the intraclass correlation coefficient (ICC) which was 0,77 for SENS and 0,88 for the SHS score. The intraobserver reliability was 0,76 vs 0,74 for the rheumatologist and radiologist, respectively. Conclusion : The performances of SENS method were good and the reading was very fast and easy. The agreement between the readers was higher for the more detailed SHS score.

Radiographic scoring methods in hand osteoarthritis – a systematic literature search and descriptive review

This systematic literature review aimed to evaluate the use of conventional radiography (CR) in hand osteoarthritis (OA) and to assess the metric properties of the different radiographic scoring methods. Medical literature databases up to November 2013 were systematically reviewed for studies reporting on radiographic scoring of structural damage in hand OA. The use and metric properties of the scoring methods, including discrimination (reliability, sensitivity to change), feasibility and validity, were evaluated. Of the 48 included studies, 10 provided data on reliability, 11 on sensitivity to change, four on feasibility and 36 on validity of radiographic scoring methods. Thirteen different scoring methods have been used in studies evaluating radiographic hand OA. The number of examined joints differed extensively and the obtained scores were analyzed in various ways. The reliability of the assessed radiographic scoring methods was good for all evaluated scoring methods, for both cross-sectional and longitudinal radiographic scoring. The responsiveness to change was similar for all evaluated scoring methods. There were no major differences in feasibility between the evaluated scoring methods, although the evidence was limited. There was limited knowledge about the validity of radiographic OA findings compared with clinical nodules and deformities, whereas there was better evidence for an association between radiographic findings and symptoms and hand function. Several radiographic scoring methods are used in hand OA literature. To enhance comparability across studies in hand OA, consensus has to be reached on a preferred scoring method, the examined joints and the used presentation of data.

Reliability of Radiographic Scoring Methods in Axial Psoriatic Arthritis

Important differences exist between axial psoriatic arthritis (AxPsA) and ankylosing spondylitis (AS). The Bath Ankylosing Spondylitis Radiology Index (BASRI), the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS), and the Radiographic Ankylosing Spondylitis Spinal Score (RASSS) were developed to score AS, and the Psoriatic Arthritis Spondylitis Radiology Index (PASRI) to score AxPsA. We aimed to develop a computerized scoring application and compare the intra- and interrater reliability of these scoring systems in AS and AxPsA. A computerized scoring application was developed to facilitate the scoring of radiographic features and calculate total scores for established scoring methods for AS and AxPsA. Digital spinal radiographs of 18 patients with AS and 40 patients with AxPsA were read in random order individually by 4 rheumatologists, data were entered into the application, and scores were obtained. The intraclass correlation coefficients (ICC) of the intra- and interrater reliability of scores for each method were then computed. In AS, the intra- and interrater ICC was 0.91 and 0.80 for sacroiliitis grade, 0.96 and 0.86 for BASRI-spine, 0.98 and 0.86 for mSASSS, 0.96 and 0.75 for RASSS, and 0.99 and 0.93 for PASRI, respectively. In AxPsA, the intra- and interrater ICC was 0.81 and 0.67 for sacroiliitis grade, 0.77 and 0.52 for BASRI-spine, 0.91 and 0.65 for mSASSS, 0.90 and 0.68 for RASSS, and 0.92 and 0.88 for PASRI, respectively. Available radiographic scoring systems perform well in AS and have moderate intra- and interrater reliability when applied to AxPsA. However, PASRI may be superior for assessing structural damage in AxPsA.

Interstitial lung abnormalities in treatment-naive advanced NSCLC patients (pts): Prevalence and impact on survival.

e19030 Background: Interstitial lung diseases are associated with increased risk of lung cancer. A radiographic scoring method of interstitial lung abnormalities (ILA) on CT was previously reported...

Feasibility, Reliability, and Sensitivity to Change of Four Radiographic Scoring Methods in Patients With Psoriatic Arthritis

We set out to assess the feasibility, reliability, and sensitivity to change of 4 radiographic scoring methods in psoriatic arthritis (PsA). Hand and feet radiographs from 50 patients with PsA were scored at 2 time points by 2 assessors with each of the following methods: modified Steinbrocker score, modified Sharp score (MSS), modified Sharp/van der Heijde score (SHS), and the Ratingen score for PsA. The radiographs of 10 patients were scored by both assessors to assess reliability using intraclass correlation coefficients (ICCs). Sensitivity to change was estimated using a standardized response mean (SRM) and smallest detectable change (SDC). The patients' mean ± SD age at baseline was 50 ± 12.1 years, the mean ± SD disease duration was 10 ± 8.4 years, and the mean ± SD followup period was 25 ± 9.6 months. Intrarater reliability was excellent for all methods (ICC >0.97). Interrater reliability was highest for the SHS (ICC 0.95-0.99). The percentage SDC for the Steinbrocker method, the Ratingen method, the MSS, and the SHS was 2.9%, 2.1%, 1.4%, and 1.2%, respectively, and the SRMs were 0.46, 0.44, 0.77, and 0.79, respectively. The mean time to score each of the Steinbrocker method, the Ratingen method, the MSS, and the SHS was 6.2, 10.5, 14.6, and 14.4 minutes, respectively. The SHS method was the most reliable and sensitive to change but took longer to perform. The Steinbrocker method is the most feasible but lacks the sensitivity of the SHS. The SDC of the Ratingen method is close to that of the SHS and MSS, but is quicker to perform.

Evaluation of hip and knee joint damage in patients with rheumatoid arthritis using a newly developed radiographic scoring method (ARASHI)

Evaluation of hip and knee joint damage in patients with rheumatoid arthritis using a newly developed radiographic scoring method (ARASHI)

OP0015 Evaluation of Hip and Knee Joint Damage in Patients with Rheumatoid Arthritis Using a Newly Developed Radiographic Scoring Method (ARASHI)

BackgroundThe radiographic joint damage in patients with rheumatoid arthritis (RA) is commonly evaluated by van der Heijde total Sharp score, intended only for the assessment of small joints. For the...

SAT0402 Evaluation of weight-bearing joint damage in patients with rheumatoid arthritis using a new radiographic scoring method (ARASHI)

BackgroundThe radiographic joint damage in rheumatoid arthritis (RA) is commonly evaluated by van der Heijde total Sharp score, however only small joints of hands and feet are assessed in this...

SAT0329 Radiologic Progression of Hand Osteoarthritis (OA) Over 2.6 Years According to Various Methods of Calculation - Data from the Sekoia Trial

BackgroundHand OA is a frequent polyarticular disease. Few is known with respect to its radiological progression over time, which in addition is difficult to assess, considering that no radiographic scoring...

SP0201 Cartilage Assessment by MRI in Large and Small Joints in Rheumatoid Arthritis

The past two decades have seen unprecedented advances in therapy for rheumatoid arthritis (RA), with nine effective biological agents introduced since 1998. Each of these therapies gained regulatory approval based...