Magnetic resonance imaging of patellofemoral osteoarthritis: intertester reliability and associations with knee pain and function

  • Daniel L. RiddleEmail author
  • Josephina A. Vossen
  • Kevin B. Hoover
Original Article



We examined the intertester reliability of patellofemoral compartment (PFC) osteoarthritis (OA) severity using magnetic resonance images (MRI) and a modified Kellgren and Lawrence (K&L) system. Second, we determined if these grades were associated with clinical tests of PFC involvement or self-reported pain/difficulty with stair climbing. Third, we assessed the association between PFC OA severity and knee pain or disability, after accounting for potential confounders including tibiofemoral OA severity.


We examined the 9-year Osteoarthritis Initiative data from 114 subjects in the year prior to undergoing knee arthroplasty. The weighted kappa (κw) was used to determine intertester reliability, and the Pearson chi-square was used to assess associations among PFC OA scores and clinical tests. Multiple regressions were used to determine independent associations between self-reported pain/function and PFC OA.


Reliability was substantial (κw = 0.73 (SE = 0.05)). Chi-square associations between PFC OA severity and clinical tests were not significant (p > 0.05). Multiple regression models between PFC OA and self-reported pain or function scores were not significant (p > 0.05).


MRI-based measures of PFC OA were highly reliable indicating that musculoskeletal radiologists can reliably grade the PFCs of subjects using MRI. The extent of PFC OA is not associated with either clinical tests of PFC involvement or activities associated with PFC pain in persons with moderate to severe symptomatic tibiofemoral and PFC OA.


Function MRI Osteoarthritis Pain Patellofemoral 


Role of the funding source

The OAI is a public–private partnership comprised of five contracts funded by the National Institutes of Health. Private funding partners include Merck Research Laboratories; Novartis Pharmaceuticals Corporation, GlaxoSmithKline; and Pfizer, Inc. The authors of the current paper are not part of the OAI investigative team. The funding source played no role in the conduct or reporting of this study.

Funding information

The OAI is a public-private partnership comprised of five contracts (N01-AR-2-2258; N01-AR-2-2259; N01-AR-2-2260; N01-AR-2-2261; N01-AR-2-2262) funded by the National Institutes of Health, a branch of the Department of Health and Human Services, and conducted by the OAI Study Investigators. Private funding partners include Merck Research Laboratories; Novartis Pharmaceuticals Corporation, GlaxoSmithKline; and Pfizer, Inc. Private sector funding for the OAI is managed by the Foundation for the National Institutes of Health. This manuscript was prepared using an OAI public use data set and does not necessarily reflect the opinions or views of the OAI investigators, the NIH, or the private funding partners.

Compliance with ethical standards

The study was approved by the Institutional Review Boards at the following sites: (1) University of Pittsburgh in Pittsburgh, Pennsylvania; (2) University of Maryland in Baltimore, Maryland; (3) Ohio State University in Columbus, Ohio; and (4) Memorial Hospital of Rhode Island, in Pawtucket, Rhode Island. All subjects signed an IRB-approved consent form prior to participation.




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Copyright information

© International League of Associations for Rheumatology (ILAR) 2019

Authors and Affiliations

  1. 1.Departments of Physical Therapy, Orthopaedic Surgery and Rheumatology, Basement, West Hospital, Room B-100Virginia Commonwealth UniversityRichmondUSA
  2. 2.Department of RadiologyVirginia Commonwealth University Health SystemRichmondUSA

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