Osteoarthritis Ankle, Osteoarthritis
Conditions
Keywords
SPECT/CT, MRI, osteoarthritis, Foot and/or Ankle
Brief summary
The diagnose of symptomatic osteoarthritis in the ankle, mid- and hind foot remains challenging. There is no gold standard for the work-up and various hospitals use different protocols. Current literature shows a promising role for SPECT-CT imaging in ankle, hind- and midfoot OA. In a previous study investigating the role of SPECT-CT in a reproducible group we have observed a change in diagnosis in 53% when SPECT-CT data was added to the data of conventional workup alone. In 26% of patients addition of SPECT-CT data resulted in change of the original treatment plan. To our knowledge no prospective studies are available on this subject for both SPECT-CT and MRI. In our clinic both SPECT-CT and MRI are used in the work-up for patients with ankle, hind- and midfoot pain. Although we experience good result with SPECT-CT, MRI might be able to detect symptomatic OA as well. Moreover MRI provide more information about soft tissue and is less harmful for the patient in comparison to SPECT-CT. The aim of this study is to determine the diagnostic performance of SPECT-CT and MRI when used routinely in patients with symptomatic OA of the ankle, hind- and midfoot.
Detailed description
Objective: The objective is to determine diagnostic performance of SPECT-CT and MRI when used routinely in patients with symptomatic OA of the ankle, hind- and midfoot. Study design: Prospective cohort study. Study population: All patients ≥18years old, referred to the Martini Hospital Groningen department of Orthopedic surgery with suspected symptomatic osteoarthritis of the foot and ankle and rest pain of NRS ≥4. Main study parameters/endpoints: Main parameters will be the diagnostic performance (a.o. sensitivity and specificity, positive and negative predictive value)of SPECT-CT and MRI. The standard work up consist of questionnaires, detailed physical examination, conventional radiographic, MRI, SPECT-CT imaging and ultrasound guided injections. There are no additional risks for participating in this study compared to current standardised hospital workup.
Interventions
DIAGNOSTIC_TESTSPECT/CT
SPECT/CT of the foot and ankle
DIAGNOSTIC_TESTMRI
MRI of the foot and ankle
Sponsors
Martini Hospital Groningen
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Suspected symptomatic ankle, hind- or midfoot OA * Informed consent * Age ≥ 18 years * Average NRS ≥4 over the past week.
Exclusion criteria
* Contraindication for surgery * Contraindication for SPECT-CT or MRI * Contraindication for intra-articular injections * Isolated forefoot pathology * Fracture, ligamentous or tendon injury of the ankle, hind- and/or midfoot trauma within one year before presentation * History of neurological disease * History of foot and/or ankle surgery (affected side) * Inability to read and understand the written information
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Diagnostic accuracy of SPECT/CT and MRI | 1 year | Primary objective is to determine overall diagnostic performance (in terms of sensitivity + specificity, positive and negative predictive values, positive and negative likelihood ratios, and diagnostic odds ratio) of SPECT-CT and MRI for diagnosing symptomatic OA in the ankle, hind- and midfoot. |
Countries
Netherlands
Contacts
CONTACTArthur van Hasselt, MD
CONTACTAstrid de Vries, dr
PRINCIPAL_INVESTIGATORTom van Raaij, MD/PhD
Martini Ziekenhuis
Outcome results
None listed