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MSKI-RADS: An MRI-based Musculoskeletal Infection Reporting and Data System for the Diagnosis of Extremity Infections
Avneesh Chhabra1, Erin F Alaia1, Oganes Ashikyan1
1From the Departments of Radiology (A.C., O.A., A.E., A.K.T., P.P., U.T., F.D.S., N.R., M.G., A.H., K.S., Y.X.), Orthopaedic Surgery (A.C., K.R., D.K.W.), and Internal Medicine, Infectious Diseases (K.B.), UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-9178; Department of Radiology, NYU Langone Medical Center, New York, NY (E.F.A.); Department of Diagnostic Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Ga (P.K.W.); Department of Radiology, Hospital for Special Surgery, New York, NY (P.C.); Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, Ark (G.B., T.P.); Department of Radiology, Virginia Commonwealth University, Richmond, Va (J.A.V.); Department of Radiology, Cleveland Clinic, Cleveland, Ohio (C.S.); Department of Radiology, University of Miami Health System, Miami, Fla (F.N.C., T.S., F.F.d.S.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (A.K.); Department of Imaging, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University of Feinberg School of Medicine, Chicago, Ill (J.S.); Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (K.S.L.); Department of Radiology, University of Washington, Seattle, Wash (M.C.); and Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pa (W.B.M.).
A new Musculoskeletal Infection Reporting and Data System (MSKI-RADS) offers standardized MRI terminology for musculoskeletal infections. This validated system improves diagnostic accuracy for extremity infections, aiding consistent patient management.
Area of Science:
- Radiology
- Musculoskeletal Imaging
- Infectious Disease Imaging
Background:
- Current MRI terminology for musculoskeletal infections lacks specificity and consistency.
- This ambiguity can lead to diagnostic challenges and varied management approaches.
Purpose of the Study:
- To develop and validate an MRI-based classification and scoring system for musculoskeletal infections.
- To establish standardized terminology for reporting MRI findings of extremity infections.
Main Methods:
- A retrospective cross-sectional study designed the Musculoskeletal Infection Reporting and Data System (MSKI-RADS).
- 208 adult patients with suspected extremity infections underwent radiography and MRI.
- Interreader agreement and true-positive rates were calculated for MSKI-RADS categories.
Main Results:
- Moderate interreader agreement (ICC, 0.70) was observed among 20 radiologists.
- MSKI-RADS demonstrated higher overall reader accuracy (65%) compared to final diagnoses (55%).
- True-positive rates varied by category, with MSKI-RADS I and NOS showing the highest at 88.7%.
Conclusions:
- MSKI-RADS is a valid system for standardizing MRI terminology in peripheral extremity infections.
- The system enhances diagnostic accuracy across varying levels of musculoskeletal fellowship training.
- Standardized reporting facilitates consistent management recommendations for musculoskeletal infections.
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