Quantitative evaluation of joint space width in femorotibial osteoarthritis: comparison of three radiographic views
Quantitative evaluation of joint space width in femorotibial osteoarthritis: comparison of three radiographic views
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DOI：
10.1053/joca.1998.0118
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发表时间：
1998-07-01
影响因子：
7
通讯作者：
Vignon, E
中科院分区：
文献类型：
--
作者：
Piperno, M;Le Graverand, MPH;Vignon, E
目的：定量评价放射学方法提出，以提高检测关节间隙狭窄（JSN）在股胫骨关节炎（OA）。方法：32个连续的膝关节OA患者和5个正常对照组有三个不同的负重X线片的膝盖：（1）完全伸展时双膝前后位片（2）患者同侧足站立时一侧膝关节伸直位的前后位片（同侧足站立）;（3）双膝屈曲30 °的后前位片（Schuss观）。使用具有六级量表（JSN评分）的JSN评估和图像分析仪计算机测量，对关节间隙进行盲分析;平均关节间隙宽度（平均JSW）。测量内侧股胫OA膝关节的内侧间室、外侧股胫OA膝关节的外侧间室以及对照膝关节的两个间室。结果：10例患者术后1年行膝关节伸直位和Schuss位检查，JSN评分+/-S. D。在Schuss中，同侧足站立和膝关节伸展视图分别为2.75 +/- 1.31、1.95 +/- 1.3和1.66 +/- 1.27。平均JSW +/- s.D.在Schuss，同侧足站立和伸展膝关节视图分别为2.9 +/- 1.9 mm，3.5 +/- 1.6 mm和3.8 +/- 1.5 mm。JSN评分和平均JSW随OA严重程度的增加而增加。在对照组中，内侧隔室的JSW：在三个视图中没有变化。在Schuss视图中，对照组外侧间室的JSW明显更大。术后1年，Schuss位JSW变化为-0.41mm（P=0.02），伸膝位JSW变化为-0.17mm（P > 0.05）。
Objective: Quantitative evaluation of radiographic methods proposed to improve the detection of joint space narrowing (JSN) in femorotibial osteoarthritis (OA).Methods: Thirty-two consecutive patients with knee OA and five normal controls had three different weight-bearing radiographs of the knee: (1) anteroposterior film of both knees in full extension (extended knees), (2) anteroposterior film of one knee in extension while the patient was standing on the homolateral foot (standing on homolateral foot), (3) posteroanterior film of both knees flexed at 30 degrees (schuss view). Joint space was analyzed blind using both an evaluation of JSN with a six-grade scale (JSN score) and an image analyser computer measurement; of the mean joint space width (mean JSW). The medial compartments of medial femorotibial OA knees, the lateral compartment of lateral femorotibial OA knees, as well as both compartments of control knees, were measured. Extended knee and schuss views were made 1 year later in 10 patients for the evaluation of sensitivity to change.Results: The JSN scores +/- S.D. in schuss, standing on the homolateral foot and extended knee views were 2.75 +/- 1.31, 1.95 +/- 1.3 and 1.66 +/- 1.27, respectively. The mean JSW +/- s.D. in schuss, standing on the homolateral foot, and extended knee views were 2.9 +/- 1.9 mm, 3.5 +/- 1.6 mm and 3.8 +/- 1.5 mm, respectively. Changes in JSN scores and mean JSW with schuss view increased with OA severity. In controls, JSW of the medial compartment: did not vary in the three views. JSW of the lateral compartment of controls was significantly larger in the schuss view. The change in JSW after 1 year was -0.41 mm (P=0.02) in the schuss view and -0.17 mm (P > 0.05) in the extended knee view.Conclusion: The schuss view is suggested as the most accurate method for the evaluation of JSW in femorotibial OA.