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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Definition of osteoarthritis on MRI: results of a Delphi exercise</title><author><name sortKey="Hunter, D J" sort="Hunter, D J" uniqKey="Hunter D" first="D. J." last="Hunter">D. J. Hunter</name><affiliation><nlm:aff id="A1"> Rheumatology Department, Royal North Shore Hospital and Northern Clinical School, University of Sydney, Sydney, NSW, Australia</nlm:aff></affiliation></author><author><name sortKey="Arden, N" sort="Arden, N" uniqKey="Arden N" first="N." last="Arden">N. Arden</name><affiliation><nlm:aff id="A2"> NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, England, UK</nlm:aff></affiliation></author><author><name sortKey="Conaghan, P G" sort="Conaghan, P G" uniqKey="Conaghan P" first="P. G." last="Conaghan">P. G. Conaghan</name><affiliation><nlm:aff id="A3"> Section of Musculoskeletal Disease, University of Leeds & NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK</nlm:aff></affiliation></author><author><name sortKey="Eckstein, F" sort="Eckstein, F" uniqKey="Eckstein F" first="F." last="Eckstein">F. Eckstein</name><affiliation><nlm:aff id="A4"> Institute of Anatomy and Musculoskeletal Research, Paracelsus Medical University, Salzburg, Austria & Chondrometrics GmbH, Ainring, Germany</nlm:aff></affiliation></author><author><name sortKey="Gold, G" sort="Gold, G" uniqKey="Gold G" first="G." last="Gold">G. Gold</name><affiliation><nlm:aff id="A5"> Department of Radiology, Stanford University, Stanford, CA, USA</nlm:aff></affiliation><affiliation><nlm:aff id="A6"> Department of Bioengineering, Stanford University, Stanford, CA, USA</nlm:aff></affiliation><affiliation><nlm:aff id="A7"> Department of Orthopaedic Surgery, Stanford University, Stanford, CA, USA</nlm:aff></affiliation></author><author><name sortKey="Grainger, A" sort="Grainger, A" uniqKey="Grainger A" first="A." last="Grainger">A. Grainger</name><affiliation><nlm:aff id="A8"> Department of Radiology, Leeds Teaching Hospitals & NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK</nlm:aff></affiliation></author><author><name sortKey="Guermazi, A" sort="Guermazi, A" uniqKey="Guermazi A" first="A." last="Guermazi">A. Guermazi</name><affiliation><nlm:aff id="A9"> Department of Radiology, Boston University School of Medicine, Boston, MA, USA</nlm:aff></affiliation></author><author><name sortKey="Harvey, W" sort="Harvey, W" uniqKey="Harvey W" first="W." last="Harvey">W. Harvey</name><affiliation><nlm:aff id="A10"> Division of Rheumatology, Tufts Medical Center, Boston, MA, USA</nlm:aff></affiliation></author><author><name sortKey="Jones, G" sort="Jones, G" uniqKey="Jones G" first="G." last="Jones">G. Jones</name><affiliation><nlm:aff id="A11"> Menzies Research Institute, Private Bag 23, Hobart, Tasmania, Australia</nlm:aff></affiliation></author><author><name sortKey="Hellio Le Graverand, M P" sort="Hellio Le Graverand, M P" uniqKey="Hellio Le Graverand M" first="M. P." last="Hellio Le Graverand">M. P. Hellio Le Graverand</name><affiliation><nlm:aff id="A12"> Clinical Development and Medical Affairs, Pfizer, New London, CT, USA</nlm:aff></affiliation></author><author><name sortKey="Laredo, J D" sort="Laredo, J D" uniqKey="Laredo J" first="J. D." last="Laredo">J. D. Laredo</name><affiliation><nlm:aff id="A13"> Department of Radiology, Hôpital Lariboisière, Assistance Publique des hôpitaux de Paris et Faculté de Médecine Paris 7, France</nlm:aff></affiliation></author><author><name sortKey="Lo, G" sort="Lo, G" uniqKey="Lo G" first="G." last="Lo">G. Lo</name><affiliation><nlm:aff id="A14"> Department of Medicine, Section of Immunology, Allergy and Rheumatology, Baylor College of Medicine, Houston, TX, USA</nlm:aff></affiliation></author><author><name sortKey="Losina, E" sort="Losina, E" uniqKey="Losina E" first="E." last="Losina">E. Losina</name><affiliation><nlm:aff id="A15"> Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston University School of Public Health, Boston, MA, USA</nlm:aff></affiliation><affiliation><nlm:aff id="A16"> Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA</nlm:aff></affiliation></author><author><name sortKey="Mosher, T J" sort="Mosher, T J" uniqKey="Mosher T" first="T. J." last="Mosher">T. J. Mosher</name><affiliation><nlm:aff id="A17"> Department of Radiology, Penn State University College of Medicine, Hershey, PA, USA</nlm:aff></affiliation></author><author><name sortKey="Roemer, F" sort="Roemer, F" uniqKey="Roemer F" first="F." last="Roemer">F. Roemer</name><affiliation><nlm:aff id="A9"> Department of Radiology, Boston University School of Medicine, Boston, MA, USA</nlm:aff></affiliation><affiliation><nlm:aff id="A18"> Department of Radiology, Klinikum Augsburg, Augsburg, Germany</nlm:aff></affiliation></author><author><name sortKey="Zhang, W" sort="Zhang, W" uniqKey="Zhang W" first="W." last="Zhang">W. Zhang</name><affiliation><nlm:aff id="A19"> Academic Rheumatology, The University of Nottingham, Nottingham, UK</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">21620986</idno><idno type="pmc">3261513</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3261513</idno><idno type="RBID">PMC:3261513</idno><idno type="doi">10.1016/j.joca.2011.04.017</idno><date when="2011">2011</date><idno type="wicri:Area/Pmc/Corpus">001560</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001560</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Definition of osteoarthritis on MRI: results of a Delphi exercise</title><author><name sortKey="Hunter, D J" sort="Hunter, D J" uniqKey="Hunter D" first="D. J." last="Hunter">D. J. Hunter</name><affiliation><nlm:aff id="A1"> Rheumatology Department, Royal North Shore Hospital and Northern Clinical School, University of Sydney, Sydney, NSW, Australia</nlm:aff></affiliation></author><author><name sortKey="Arden, N" sort="Arden, N" uniqKey="Arden N" first="N." last="Arden">N. Arden</name><affiliation><nlm:aff id="A2"> NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, England, UK</nlm:aff></affiliation></author><author><name sortKey="Conaghan, P G" sort="Conaghan, P G" uniqKey="Conaghan P" first="P. G." last="Conaghan">P. G. Conaghan</name><affiliation><nlm:aff id="A3"> Section of Musculoskeletal Disease, University of Leeds & NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK</nlm:aff></affiliation></author><author><name sortKey="Eckstein, F" sort="Eckstein, F" uniqKey="Eckstein F" first="F." last="Eckstein">F. Eckstein</name><affiliation><nlm:aff id="A4"> Institute of Anatomy and Musculoskeletal Research, Paracelsus Medical University, Salzburg, Austria & Chondrometrics GmbH, Ainring, Germany</nlm:aff></affiliation></author><author><name sortKey="Gold, G" sort="Gold, G" uniqKey="Gold G" first="G." last="Gold">G. Gold</name><affiliation><nlm:aff id="A5"> Department of Radiology, Stanford University, Stanford, CA, USA</nlm:aff></affiliation><affiliation><nlm:aff id="A6"> Department of Bioengineering, Stanford University, Stanford, CA, USA</nlm:aff></affiliation><affiliation><nlm:aff id="A7"> Department of Orthopaedic Surgery, Stanford University, Stanford, CA, USA</nlm:aff></affiliation></author><author><name sortKey="Grainger, A" sort="Grainger, A" uniqKey="Grainger A" first="A." last="Grainger">A. Grainger</name><affiliation><nlm:aff id="A8"> Department of Radiology, Leeds Teaching Hospitals & NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK</nlm:aff></affiliation></author><author><name sortKey="Guermazi, A" sort="Guermazi, A" uniqKey="Guermazi A" first="A." last="Guermazi">A. Guermazi</name><affiliation><nlm:aff id="A9"> Department of Radiology, Boston University School of Medicine, Boston, MA, USA</nlm:aff></affiliation></author><author><name sortKey="Harvey, W" sort="Harvey, W" uniqKey="Harvey W" first="W." last="Harvey">W. Harvey</name><affiliation><nlm:aff id="A10"> Division of Rheumatology, Tufts Medical Center, Boston, MA, USA</nlm:aff></affiliation></author><author><name sortKey="Jones, G" sort="Jones, G" uniqKey="Jones G" first="G." last="Jones">G. Jones</name><affiliation><nlm:aff id="A11"> Menzies Research Institute, Private Bag 23, Hobart, Tasmania, Australia</nlm:aff></affiliation></author><author><name sortKey="Hellio Le Graverand, M P" sort="Hellio Le Graverand, M P" uniqKey="Hellio Le Graverand M" first="M. P." last="Hellio Le Graverand">M. P. Hellio Le Graverand</name><affiliation><nlm:aff id="A12"> Clinical Development and Medical Affairs, Pfizer, New London, CT, USA</nlm:aff></affiliation></author><author><name sortKey="Laredo, J D" sort="Laredo, J D" uniqKey="Laredo J" first="J. D." last="Laredo">J. D. Laredo</name><affiliation><nlm:aff id="A13"> Department of Radiology, Hôpital Lariboisière, Assistance Publique des hôpitaux de Paris et Faculté de Médecine Paris 7, France</nlm:aff></affiliation></author><author><name sortKey="Lo, G" sort="Lo, G" uniqKey="Lo G" first="G." last="Lo">G. Lo</name><affiliation><nlm:aff id="A14"> Department of Medicine, Section of Immunology, Allergy and Rheumatology, Baylor College of Medicine, Houston, TX, USA</nlm:aff></affiliation></author><author><name sortKey="Losina, E" sort="Losina, E" uniqKey="Losina E" first="E." last="Losina">E. Losina</name><affiliation><nlm:aff id="A15"> Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston University School of Public Health, Boston, MA, USA</nlm:aff></affiliation><affiliation><nlm:aff id="A16"> Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA</nlm:aff></affiliation></author><author><name sortKey="Mosher, T J" sort="Mosher, T J" uniqKey="Mosher T" first="T. J." last="Mosher">T. J. Mosher</name><affiliation><nlm:aff id="A17"> Department of Radiology, Penn State University College of Medicine, Hershey, PA, USA</nlm:aff></affiliation></author><author><name sortKey="Roemer, F" sort="Roemer, F" uniqKey="Roemer F" first="F." last="Roemer">F. Roemer</name><affiliation><nlm:aff id="A9"> Department of Radiology, Boston University School of Medicine, Boston, MA, USA</nlm:aff></affiliation><affiliation><nlm:aff id="A18"> Department of Radiology, Klinikum Augsburg, Augsburg, Germany</nlm:aff></affiliation></author><author><name sortKey="Zhang, W" sort="Zhang, W" uniqKey="Zhang W" first="W." last="Zhang">W. Zhang</name><affiliation><nlm:aff id="A19"> Academic Rheumatology, The University of Nottingham, Nottingham, UK</nlm:aff></affiliation></author></analytic><series><title level="j">Osteoarthritis and Cartilage</title><idno type="ISSN">1063-4584</idno><idno type="eISSN">1522-9653</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>summary</title><sec id="S1"><title>Objective</title><p id="P1">Despite a growing body of Magnetic Resonance Imaging (MRI) literature in osteoarthritis (OA), there is little uniformity in its diagnostic application. We envisage in the first instance the definition requiring further validation and testing in the research setting before considering implementation/feasibility testing in the clinical setting. The objective of our research was to develop an MRI definition of structural OA.</p></sec><sec sec-type="methods" id="S2"><title>Methods</title><p id="P2">We undertook a multistage process consisting of a number of different steps. The intent was to develop testable definitions of OA (knee, hip and/or hand) on MRI. This was an evidence driven approach with results of a systematic review provided to the group prior to a Delphi exercise. Each participant of the steering group was allowed to submit independently up to five propositions related to key aspects in MRI diagnosis of knee OA. The steering group then participated in a Delphi exercise to reach consensus on which propositions we would recommend for a definition of structural OA on MRI. For each round of voting, ≥60% votes led to include and ≥20% votes led to exclude a proposition. After developing the proposition one of the definitions developed was tested for its validity against radiographic OA in an extant database.</p></sec><sec id="S3"><title>Results</title><p id="P3">For the systematic review we identified 25 studies which met all of our inclusion criteria and contained relevant diagnostic measure and performance data. At the completion of the Delphi voting exercise 11 propositions were accepted for definition of structural OA on MRI. We assessed the diagnostic performance of the tibiofemoral MRI definition against a radiographic reference standard. The diagnostic performance for individual features was: osteophyte C statistic = 0.61, for cartilage loss C statistic = 0.73, for bone marrow lesions C statistic= 0.72 and for meniscus tear in any region C statistic = 0.78. The overall composite model for these four features was a C statistic = 0.59. We detected good specificity (1) but less optimal sensitivity (0.46) likely due to detection of disease earlier on MRI.</p></sec><sec id="S4"><title>Conclusion</title><p id="P4">We have developed MRI definition of knee OA that requires further formal testing with regards their diagnostic performance (especially in datasets of persons with early disease), before they are more widely used. Our current analysis suggests that further testing should focus on comparisons other than the radiograph, that may capture later stage disease and thus nullify the potential for detecting early disease that MRI may afford. The propositions are not to detract from, nor to discourage the use of traditional means of diagnosing OA.</p></sec></div></front></TEI><pmc article-type="research-article" xml:lang="en"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">9305697</journal-id><journal-id journal-id-type="pubmed-jr-id">8786</journal-id><journal-id journal-id-type="nlm-ta">Osteoarthritis Cartilage</journal-id><journal-title-group><journal-title>Osteoarthritis and Cartilage</journal-title></journal-title-group><issn pub-type="ppub">1063-4584</issn><issn pub-type="epub">1522-9653</issn></journal-meta><article-meta><article-id pub-id-type="pmid">21620986</article-id><article-id pub-id-type="pmc">3261513</article-id><article-id pub-id-type="doi">10.1016/j.joca.2011.04.017</article-id><article-id pub-id-type="manuscript">NIHMS348925</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Definition of osteoarthritis on MRI: results of a Delphi exercise</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Hunter</surname><given-names>D.J.</given-names></name><xref ref-type="aff" rid="A1">†</xref><xref ref-type="corresp" rid="CR1">*</xref></contrib><contrib contrib-type="author"><name><surname>Arden</surname><given-names>N.</given-names></name><xref ref-type="aff" rid="A2">‡</xref></contrib><contrib contrib-type="author"><name><surname>Conaghan</surname><given-names>P.G.</given-names></name><xref ref-type="aff" rid="A3">§</xref></contrib><contrib contrib-type="author"><name><surname>Eckstein</surname><given-names>F.</given-names></name><xref ref-type="aff" rid="A4">∥</xref></contrib><contrib contrib-type="author"><name><surname>Gold</surname><given-names>G.</given-names></name><xref ref-type="aff" rid="A5">¶</xref><xref ref-type="aff" rid="A6">#</xref><xref ref-type="aff" rid="A7">††</xref></contrib><contrib contrib-type="author"><name><surname>Grainger</surname><given-names>A.</given-names></name><xref ref-type="aff" rid="A8">‡‡</xref></contrib><contrib contrib-type="author"><name><surname>Guermazi</surname><given-names>A.</given-names></name><xref ref-type="aff" rid="A9">§§</xref></contrib><contrib contrib-type="author"><name><surname>Harvey</surname><given-names>W.</given-names></name><xref ref-type="aff" rid="A10">∥∥</xref></contrib><contrib contrib-type="author"><name><surname>Jones</surname><given-names>G.</given-names></name><xref ref-type="aff" rid="A11">¶¶</xref></contrib><contrib contrib-type="author"><name><surname>Hellio Le Graverand</surname><given-names>M.P.</given-names></name><xref ref-type="aff" rid="A12">##</xref></contrib><contrib contrib-type="author"><name><surname>Laredo</surname><given-names>J.D.</given-names></name><xref ref-type="aff" rid="A13">†††</xref></contrib><contrib contrib-type="author"><name><surname>Lo</surname><given-names>G.</given-names></name><xref ref-type="aff" rid="A14">‡‡‡</xref></contrib><contrib contrib-type="author"><name><surname>Losina</surname><given-names>E.</given-names></name><xref ref-type="aff" rid="A15">§§§</xref><xref ref-type="aff" rid="A16">∥∥∥</xref></contrib><contrib contrib-type="author"><name><surname>Mosher</surname><given-names>T.J.</given-names></name><xref ref-type="aff" rid="A17">¶¶¶</xref></contrib><contrib contrib-type="author"><name><surname>Roemer</surname><given-names>F.</given-names></name><xref ref-type="aff" rid="A9">§§</xref><xref ref-type="aff" rid="A18">###</xref></contrib><contrib contrib-type="author"><name><surname>Zhang</surname><given-names>W.</given-names></name><xref ref-type="aff" rid="A19">††††</xref><on-behalf-of>on behalf of the OARSI OA Imaging Working Group</on-behalf-of></contrib></contrib-group><aff id="A1"><label>†</label> Rheumatology Department, Royal North Shore Hospital and Northern Clinical School, University of Sydney, Sydney, NSW, Australia</aff><aff id="A2"><label>‡</label> NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, England, UK</aff><aff id="A3"><label>§</label> Section of Musculoskeletal Disease, University of Leeds & NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK</aff><aff id="A4"><label>∥</label> Institute of Anatomy and Musculoskeletal Research, Paracelsus Medical University, Salzburg, Austria & Chondrometrics GmbH, Ainring, Germany</aff><aff id="A5"><label>¶</label> Department of Radiology, Stanford University, Stanford, CA, USA</aff><aff id="A6"><label>#</label> Department of Bioengineering, Stanford University, Stanford, CA, USA</aff><aff id="A7"><label>††</label> Department of Orthopaedic Surgery, Stanford University, Stanford, CA, USA</aff><aff id="A8"><label>‡‡</label> Department of Radiology, Leeds Teaching Hospitals & NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK</aff><aff id="A9"><label>§§</label> Department of Radiology, Boston University School of Medicine, Boston, MA, USA</aff><aff id="A10"><label>∥∥</label> Division of Rheumatology, Tufts Medical Center, Boston, MA, USA</aff><aff id="A11"><label>¶¶</label> Menzies Research Institute, Private Bag 23, Hobart, Tasmania, Australia</aff><aff id="A12"><label>##</label> Clinical Development and Medical Affairs, Pfizer, New London, CT, USA</aff><aff id="A13"><label>†††</label> Department of Radiology, Hôpital Lariboisière, Assistance Publique des hôpitaux de Paris et Faculté de Médecine Paris 7, France</aff><aff id="A14"><label>‡‡‡</label> Department of Medicine, Section of Immunology, Allergy and Rheumatology, Baylor College of Medicine, Houston, TX, USA</aff><aff id="A15"><label>§§§</label> Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston University School of Public Health, Boston, MA, USA</aff><aff id="A16"><label>∥∥∥</label> Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA</aff><aff id="A17"><label>¶¶¶</label> Department of Radiology, Penn State University College of Medicine, Hershey, PA, USA</aff><aff id="A18"><label>###</label> Department of Radiology, Klinikum Augsburg, Augsburg, Germany</aff><aff id="A19"><label>††††</label> Academic Rheumatology, The University of Nottingham, Nottingham, UK</aff><author-notes><corresp id="CR1"><label>*</label>Address correspondence and reprint requests to: D.J. Hunter, Rheumatology Department, Royal North Shore Hospital and Northern Clinical School, University of Sydney, Sydney, NSW 2066, Australia. Tel: 61-2-9926-7379; Fax: 61-2-9906-1859. <email>david.hunter@sydney.edu.au</email> (D.J. Hunter)</corresp></author-notes><pub-date pub-type="nihms-submitted"><day>11</day><month>1</month><year>2012</year></pub-date><pub-date pub-type="epub"><day>12</day><month>5</month><year>2011</year></pub-date><pub-date pub-type="ppub"><month>8</month><year>2011</year></pub-date><pub-date pub-type="pmc-release"><day>1</day><month>8</month><year>2012</year></pub-date><volume>19</volume><issue>8</issue><fpage>963</fpage><lpage>969</lpage><permissions><copyright-statement>© 2011 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved</copyright-statement><copyright-year>2011</copyright-year></permissions><abstract><title>summary</title><sec id="S1"><title>Objective</title><p id="P1">Despite a growing body of Magnetic Resonance Imaging (MRI) literature in osteoarthritis (OA), there is little uniformity in its diagnostic application. We envisage in the first instance the definition requiring further validation and testing in the research setting before considering implementation/feasibility testing in the clinical setting. The objective of our research was to develop an MRI definition of structural OA.</p></sec><sec sec-type="methods" id="S2"><title>Methods</title><p id="P2">We undertook a multistage process consisting of a number of different steps. The intent was to develop testable definitions of OA (knee, hip and/or hand) on MRI. This was an evidence driven approach with results of a systematic review provided to the group prior to a Delphi exercise. Each participant of the steering group was allowed to submit independently up to five propositions related to key aspects in MRI diagnosis of knee OA. The steering group then participated in a Delphi exercise to reach consensus on which propositions we would recommend for a definition of structural OA on MRI. For each round of voting, ≥60% votes led to include and ≥20% votes led to exclude a proposition. After developing the proposition one of the definitions developed was tested for its validity against radiographic OA in an extant database.</p></sec><sec id="S3"><title>Results</title><p id="P3">For the systematic review we identified 25 studies which met all of our inclusion criteria and contained relevant diagnostic measure and performance data. At the completion of the Delphi voting exercise 11 propositions were accepted for definition of structural OA on MRI. We assessed the diagnostic performance of the tibiofemoral MRI definition against a radiographic reference standard. The diagnostic performance for individual features was: osteophyte C statistic = 0.61, for cartilage loss C statistic = 0.73, for bone marrow lesions C statistic= 0.72 and for meniscus tear in any region C statistic = 0.78. The overall composite model for these four features was a C statistic = 0.59. We detected good specificity (1) but less optimal sensitivity (0.46) likely due to detection of disease earlier on MRI.</p></sec><sec id="S4"><title>Conclusion</title><p id="P4">We have developed MRI definition of knee OA that requires further formal testing with regards their diagnostic performance (especially in datasets of persons with early disease), before they are more widely used. Our current analysis suggests that further testing should focus on comparisons other than the radiograph, that may capture later stage disease and thus nullify the potential for detecting early disease that MRI may afford. The propositions are not to detract from, nor to discourage the use of traditional means of diagnosing OA.</p></sec></abstract><kwd-group><kwd>Osteoarthritis</kwd><kwd>Magnetic resonance imaging</kwd><kwd>Diagnosis</kwd></kwd-group><funding-group><award-group><funding-source country="United States">National Institute of Arthritis and Musculoskeletal and Skin Diseases : NIAMS</funding-source><award-id>R01 AR053112-02 || AR</award-id></award-group><award-group><funding-source country="United States">National Institute of Arthritis and Musculoskeletal and Skin Diseases : NIAMS</funding-source><award-id>K24 AR057827-03 || AR</award-id></award-group></funding-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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