In:
Skeletal Radiology, Springer Science and Business Media LLC, Vol. 50, No. 2 ( 2021-02), p. 311-320
Kurzfassung:
To develop a new magnetic resonance imaging(MRI) scoring system for evaluation of active Charcot foot and to correlate the score with a duration of off-loading treatment ≥ 90 days. Methods An outpatient clinic database was searched retrospectively for MRIs of patients with active Charcot foot who completed off-loading treatment. Images were assessed by two radiologists (readers 1 and 2) and an orthopedic surgeon (reader 3). Sanders/Frykberg regions I–V were evaluated for soft tissue edema, bone marrow edema, erosions, subchondral cysts, joint destruction, fractures, and overall regional manifestation using a score according to degree of severity (0–3 points). Intraclass correlations (ICC) for interreader agreement and receiver operating characteristic analysis between MR findings and duration of off-loading-treatment were calculated. Results Sixty-five feet in 56 patients (34 men) with a mean age of 62.4 years (range: 44.5–85.5) were included. Region III (reader 1/reader 2: 93.6/90.8%) and region II (92.3/90.8%) were most affected. The most common findings in all regions were soft tissue edema and bone marrow edema. Mean time between MRI and cessation of off-loading-treatment was 150 days (range: 21–405). The Balgrist Score was defined in regions II and III using soft tissue edema, bone marrow edema, joint destruction, and fracture. Interreader agreement for Balgrist Score was excellent: readers 1/2: ICC 0.968 (95% CI: 0.948, 0.980); readers 1/2/3: ICC 0.856 (0.742, 0.917). A cutoff of ≥ 9.0 points in Balgrist Score (specificity 72%, sensitivity 66%) indicated a duration of off-loading treatment ≥ 90 days. Conclusion The Balgrist Score is a new MR scoring system for assessment of active Charcot foot with excellent interreader agreement. The Balgrist Score can help to identify patients with off-loading treatment ≥ 90 days.
Materialart:
Online-Ressource
ISSN:
0364-2348
,
1432-2161
DOI:
10.1007/s00256-020-03541-6
Sprache:
Englisch
Verlag:
Springer Science and Business Media LLC
Publikationsdatum:
2021
ZDB Id:
1461957-X
