Painful type II os naviculare: introduction of a standardized, reproducible classification system

Objective To provide a novel MRI classification system for the symptomatic type II os naviculare by creating a standardized grading of associated bone marrow edema (BME) and correlating with patient symptoms. Methods BME was classified on an ordinal scale: grade 1, faint signal immediately adjacent...

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Bibliographic Details
Published in:Skeletal radiology 2020-12, Vol.49 (12), p.1977-1985
Main Authors: Kamel, Sarah I., Belair, Jeffrey A., Hegazi, Tarek M., Halpern, Ethan J., Desai, Vishal, Morrison, William B., Zoga, Adam C.
Format: Article
Language:English
Subjects:
Ankle
Biomechanics
Bone marrow
Classification
Compression
Correlation analysis
Correlation coefficients
Edema
Imaging
Magnetic resonance imaging
Medical imaging equipment
Medical research
Medicine
Medicine & Public Health
Medicine, Experimental
Nuclear Medicine
Orthopedics
Pain
Pathology
Radiology
Scientific Article
Soft tissues
Trauma
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Summary:Objective To provide a novel MRI classification system for the symptomatic type II os naviculare by creating a standardized grading of associated bone marrow edema (BME) and correlating with patient symptoms. Methods BME was classified on an ordinal scale: grade 1, faint signal immediately adjacent to the synchondrosis; grade 2, intermediate signal within the os and navicular tuberosity without extending to the navicular body; grade 3, intense signal extending to the navicular body. BME on 59 MRIs was independently graded by three radiologists. Inter- and intra-observer agreement was analyzed using intraclass correlation coefficient. Univariate and multivariate analyses assessed for patient and imaging characteristics predictive of subjective pain score. A cohort of 82 patients without BME represented a control group. Results Inter-observer agreement of BME grade was 0.95 (CI 0.93–0.97) and intra-observer was 0.92 (CI 0.87–0.96), indicating excellent agreement. In patients with BME, predictors of more severe pain were longer duration of pain ( p  = 0.02) and presence of soft tissue edema overlying the os naviculare ( p  
ISSN:0364-2348
1432-2161
DOI:10.1007/s00256-020-03503-y