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Multicenter Study
. 2009 Jun;17(6):761-5.
doi: 10.1016/j.joca.2008.11.001. Epub 2008 Nov 12.

Location specific radiographic joint space width for osteoarthritis progression

G Neumann  1 , D Hunter, M Nevitt, L B Chibnik, K Kwoh, H Chen, T Harris, S Satterfield, J Duryea; Health ABC Study
Affiliations
Multicenter Study

Location specific radiographic joint space width for osteoarthritis progression

G Neumann et al. Osteoarthritis Cartilage. 2009 Jun.

Abstract

Objective: To establish the performance of location specific computer measures of radiographic joint space width (JSW) compared to measurements of minimum joint space width (mJSW) for the assessment of medial compartment knee osteoarthritis (OA). The study also investigated the most disease-responsive location for measuring medial compartment JSW.

Methods: Serial bilateral Posterior Anterior (PA) conventional radiographs acquired with a fixed flexion protocol were obtained 36 months apart in 118 persons with knee OA participating in the Health, Aging and Body Composition (Health ABC) Study. Measurements of medial compartment mJSW and JSW at seven fixed locations were facilitated by the use of semi-automated software that delineated the femoral and tibial margins of the joint. A human reader operated custom software to verify and correct the software-drawn margins where necessary. Paired images were displayed with the reader blinded to the chronological order. The amount of joint space narrowing was measured and the standardized response mean (SRM) was used as a metric to quantify performance.

Results: For all subjects, the mJSW SRM value was 0.42 while, for the most responsive location specific measure of JSW, it was SRM=0.46. For subjects with a Kellgren-Lawrence (KL) score less than or equal to 1, mJSW (SRM=0.40) was more responsive than the new measures (Maximum SRM=0.30). For KL=2or3, SRM=0.49 for mJSW, and SRM=0.74 for the most responsive location specific measure of JSW. Improved responsiveness was observed in the more central portion of the joint on the more diseased knees.

Conclusions: Location specific computer measures of JSW are feasible and potentially provide a superior method to assess radiographic OA for more diseased subjects. This new measure has the potential to improve the power of clinical studies that use a fixed flexion protocol.

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Conflict of interest statement

Conflict of interest

There are no conflicts of interest of any authors with the work presented in this manuscript.

Figures

Fig. 1
Fig. 1
Typical output of knee radiograph analysis software showing the delineation of the femoral condyle and the tibial plateaus, and the mJSW locations.
Fig. 2
Fig. 2
Examples of problematic medial compartment knee radiographs from our data where the location specific JSW may provide a more robust metric. In (a) sub optimal patient positioning causes the femur and tibia margins to continuously converge resulting in no local minimum. In (b) joint attrition causes different locations for mJSW in the baseline and follow-up images.
Fig. 3
Fig. 3
Landmarks and definition of coordinate system.
Fig. 4
Fig. 4
Location specific measurement of JSW, JSW(x), (x = 0.125–0.275), in the medial compartment. Measurements of JSW(x) are made at the x-locations defined by the coordinate system.
See this image and copyright information in PMC

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