The Relationship of Three-Dimensional Joint Space Width on Weight Bearing CT With Pain and Physical Function

Abstract

Limitations of plain radiographs may contribute to poor sensitivity in the detection of knee osteoarthritis and poor correlation with pain and physical function. 3D joint space width, measured from weight bearing CT images, may yield a more accurate correlation with patients' symptoms. We assessed the cross-sectional association between 3D joint space width and self-reported pain and physical function. 528 knees (57% women) were analyzed from Multicenter Osteoarthritis Study participants. An upright weight bearing CT scanner was used to acquire bilateral, weight-bearing fixed-flexion images of the knees. A 3D dataset was reconstructed from cone beam projections and joint space width was calculated across the joint surface. The percentages of the apposed medial tibiofemoral joint surface with joint space width <2.0mm and <2.5mm respectively were calculated. Pain and physical function were measured using Western Ontario and McMaster Universities Osteoarthritis Index. Participants who reported greater pain severity tended to have a greater joint area with joint space width <2.0mm (p=.07 for the highest vs. the lowest tertile). Participants who reported greater functional limitations had a greater joint area with joint space width <2.0mm (p=.02 for the highest vs. the lowest tertile). There appears to be an association between the medial tibiofemoral area with joint space width <2.0mm and pain and physical function. This article is protected by copyright. All rights reserved.

Keywords: Arthralgia; Imaging; Physical Function; Three-dimensional; Knee Joint.

Figure 1:

3D JSW measurement methods, from A) WBCT images to B) 3D models to C) 3D JSW maps

Figure 2:

Diagram of inclusion and exclusion of potential participants

Figure 3:

Boxplot illustrating the percent joint area with JSW <2.0mm (y-axis) for each A) WOMAC Pain tertile (x-axis) and B) WOMAC Physical Function tertile (x-axis)