The usefulness of computer-aided joint space analysis in the assessment of rheumatoid arthritis

Abstract

Objective: Computer-aided joint space analysis (CAJSA) is a newly developed technique for the measurement of radiogeometrically detectable joint space widths of the metacarpal-phalangeal (JSD-MCP) and proximal-interphalangeal articulations (JSD-PIP). The aim of this study was to verify the sensitivity and specificity of these CAJSA measurements in the assessment of established RA.

Methods: Four hundred and fifty-eight participants (248 healthy subjects, 210 RA patients) underwent computerized semi-automated measurements of the JSD-MCP and JSD-PIP articulations (CAJSA, Radiogrammetry Kit, Version 1.3.6) based on digitally performed radiographs. The Sharp joint space narrowing score was also performed to determine RA-related joint space narrowing.

Results: The significant severity-dependent reduction for JSD-MCP was -44.0% and for JSD-PIP, -25.94% between Sharp scores 0 and 3. The sensitivity and specificity of JSD-MCP (total) was 88.1% versus 77.8%, respectively (AUC = 0.920; P < 0.001). Furthermore, JSD-PIP (total) revealed a lower sensitivity and specificity with 61.4% and 88.7% (AUC = 0.878; P < 0.001).

Conclusion: The CAJSA method presented a reliable assessment of disease-related joint space narrowing in patients suffering from RA with excellent sensitivity and specificity. By providing quantitative data, other scoring methods could be significantly improved, and thereby the accuracy of the diagnosis and a better therapeutic evaluation could be achieved.

Keywords: AUC; Area under the curve; CAD; CAJSA; CV; Coefficient of variation; Computer-aided diagnosis; Computer-aided joint space analysis; Finger; JSD; JSD-MCP; JSD-PIP; Joint space distance; Joint space distance of the metacarpal-phalangeal joint; Joint space distance of the proximal-interphalangeal joint; Joint space width; MCP; Metacarpal-phalangeal joint; PIP; Proximal-interphalangeal joint; RA; Rheumatoid arthritis; SD; Sharp score; Standard deviation.