Validating a new computed tomography atlas for grading ankle osteoarthritis

Area of Science:

• Orthopedics
• Radiology
• Medical Imaging

Background:

• Osteoarthritis (OA) is a prevalent joint disease causing pain and disability.
• Existing grading scales for OA are insufficient for the ankle joint.
• Standardized classification is needed for ankle OA assessment.

Purpose of the Study:

• To create and validate a standardized computed tomography (CT) atlas for grading ankle osteoarthritis (OA).
• To adapt "hallmark" findings from the Kellgren-Lawrence scale for ankle OA staging on CT.
• To provide a reliable tool for clinical and research use in ankle OA.

Main Methods:

• Retrospective review of 226 patient CT scans to derive an atlas.
• Development of the atlas using 30 CT scans and validation with 11 patient CT scans.
• Independent rating of CT scans by a 9-examiner multispecialty panel to assess inter-rater reliability.

Main Results:

• The developed CT ankle OA atlas demonstrated excellent agreement among examiners across specialties.
• High intra-investigational (ICC 0.962-1) and inter-investigational (ICC 0.851) reliability values were observed.
• The atlas showed strong validity as a tool for grading ankle OA.

Conclusions:

• The CT ankle OA atlas is a validated and reliable tool for staging ankle osteoarthritis.
• This atlas is expected to be more beneficial than generalized OA grading scales.
• The tool will aid in both clinical practice and research for ankle OA.