Fixed-flexion radiography of the knee provides reproducible joint space width measurements in osteoarthritis
Fixed-flexion radiography of the knee provides reproducible joint space width measurements in osteoarthritis
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DOI：
10.1007/s00330-004-2312-6
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发表时间：
2004-09-01
影响因子：
5.9
通讯作者：
Peterfy, CG
中科院分区：
文献类型：
--
作者：
Kothari, M;Guermazi, A;Peterfy, CG
确定非透视固定屈曲X线摄影采集和分析方案用于测量膝关节骨关节炎关节间隙宽度（JSW）的有效性。对165例有记录的膝关节骨关节炎患者进行了一项横断面研究，这些患者参加了一项软骨保护剂的多中心前瞻性研究。所有患者均接受了后前位、负重、固定屈曲X线摄影，尾侧射束成角为10 °。使用专门设计的框架（SynaFlexer）来标准化定位。手动测量最小内侧和外侧JSW，并通过自动分析系统测量两次，以确定技术间和阅片员内的一致性和可靠性。随机抽取30名患者进行重复膝关节X线片检查，间隔2周，使用自动分析评估短期可重复性。手动和自动内侧JSW测量之间的一致性较高（ICC=0.90）;外侧间室测量显示一致性稍低（ICC=0.72）。间隔6个月对内侧（ICC=0.94）和外侧（ICC=0.86）间室进行的重复自动JSW测量之间具有极好的一致性。30例重复采集的子样本的短期再现性表明，内侧JSW（CV=4.3%）和外侧JSW（CV=4.0%）的平均SD分别为0.14 mm和0.23 mm。使用定位装置对膝关节进行固定屈曲X线摄影，可提供一致、可靠和可重复的膝关节骨关节炎最小JSW测量，而无需同时进行X线透视引导。
The validity of a non-fluoroscopic fixed-flexion radiographic acquisition and analysis protocol for measurement of joint space width (JSW) in knee osteoarthritis is determined. A cross-sectional study of 165 patients with documented knee osteoarthritis participating in a multicenter, prospective study of chondroprotective agents was performed. All patients had posteroanterior, weight-bearing, fixed-flexion radiography with 10degrees caudal beam angulation. A specially designed frame (SynaFlexer) was used to standardize the positioning. Minimum medial and lateral JSW were measured manually and twice by an automated analysis system to determine inter-technique and intra-reader concordance and reliability. A random subsample of 30 patients had repeat knee radiographs 2 weeks apart to estimate short-term reproducibility using automated analysis. Concordance between manual and automated medial JSW measurements was high (ICC=0.90); lateral compartment measurements showed somewhat less concordance (ICC=0.72). There was excellent concordance between repeated automated JSW measurements performed 6 months apart for the medial (ICC=0.94) and lateral (ICC=0.86) compartments. Short-term reproducibility for the subsample of 30 cases with repeat acquisitions demonstrated an average SD of 0.14 mm for medial JSW (CV=4.3%) and 0.23 mm for lateral JSW (CV=4.0%). Fixed-flexion radiography of the knee using a positioning device provides consistent, reliable and reproducible measurement of minimum JSW in knee osteoarthritis without the need for concurrent fluoroscopic guidance.