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Cited by 134Osteoarthritis Treatment and MechanismsHip disorders and treatmentsBone and Joint Diseases

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The diagnostic performance of MRI in osteoarthritis: a systematic review and meta-analysis

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Menashe, L., Hirko, K., Losina, E., Kloppenburg, M., Zhang, W., Li, L., Hunter, D.J.·2012·Osteoarthritis and Cartilage
DOI 10.1016/j.joca.2011.10.003PMC PMC3934362
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Abstract

Objective Osteoarthritis (OA) is currently diagnosed using clinical and radiographic findings. In recent years magnetic resonance imaging (MRI) use in OA has increasingly been studied. This study was conducted to determine the diagnostic utility of MRI in OA through a meta-analysis of published studies. Methods A systematic literature search was undertaken to include studies that used MRI to evaluate or detect OA. MRI was compared to various reference standards: histology, arthroscopy, radiography, CT, clinical evaluation, and direct visual inspection. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and receiver operating characteristic (ROC) area under the curve (AUC) were calculated. Random-effects models were used to pool results. Results Of 20 relevant studies identified from the literature, 16 reported complete data and were included in the meta-analysis, with a total of 1220 patients (1071 with OA and 149 without). Overall sensitivity from pooling data of all the included studies was 61% [95% confidence interval (CI) 53-68], specificity was 82% (95% CI 77-87), PPV was 85% (95% CI 80-88), and NPV was 57% (95% CI 43-70). The ROC showed an AUC of 0.804. There was significant heterogeneity in the above parameters (I(2)>83%). With histology as the reference standard, sensitivity increased to 74% and specificity decreased to 76% compared with all reference standards combined. When arthroscopy was used as the reference standard, sensitivity increased to 69% and specificity to 93% compared with all reference standards combined. Conclusion MRI can detect OA with an overall high specificity and moderate sensitivity when compared with various reference standards, thus lending more utility to ruling out OA than ruling it in. The sensitivity of MRI is below the current clinical diagnostic standards. At this time standard clinical algorithm for OA diagnosis, aided by radiographs appears to be the most effective method for diagnosing OA.

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Metadata

Authors
Menashe, L., Hirko, K., Losina, E., Kloppenburg, M., Zhang, W., Li, L., & Hunter, D. J.
Affiliations
  • Tufts University (US)
  • New England Baptist Hospital (US)
  • Boston University (US)
  • Leiden University Medical Center (NL)
  • University of Nottingham (GB)
  • The University of Sydney (AU)
Corresponding author
Hunter, D.J.
ORCID
Venue
Osteoarthritis and Cartilage
Publisher
Elsevier BV
Published
2012-01
Volume
20
Issue
1
Pages
13-21
ISSN
1063-4584 (ISSN-L)
DOI
10.1016/j.joca.2011.10.003
PMC
PMC3934362
OpenAlex
W2137908857
Cited by
134
References
2
Citations by year
2026: 4 · 2025: 7 · 2024: 12 · 2023: 13 · 2022: 5 · 2021: 10 · 2020: 16 · 2019: 13 · 2018: 13 · 2017: 4 · 2016: 7 · 2015: 11 · 2014: 6 · 2013: 10 · 2012: 3
FWCI
0.88
Type
journal article
Language
en
Open access
Licence
Locations
  • Osteoarthritis and Cartilage (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
  • Leiden Repository (Leiden University) (submittedVersion)
Funders
National Institute of Arthritis and Musculoskeletal and Skin Diseases (K24AR057827)
Topics
  • Health Sciences › Medicine › Rheumatology › Osteoarthritis Treatment and Mechanisms
  • Health Sciences › Medicine › Surgery › Hip disorders and treatments
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone and Joint Diseases
Keywords
osteoarthritis, magnetic resonance imaging, diagnostic accuracy, sensitivity and specificity, arthroscopic surgery, histology, radiography
MeSH terms
Humans, Magnetic Resonance Imaging, Osteoarthritis, Predictive Value of Tests, Radiography, Sensitivity and Specificity

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