The lateral view radiograph for assessment of the tibiofemoral joint space in knee osteoarthritis - Its reliability, sensitivity to change, and longitudinal validity
The lateral view radiograph for assessment of the tibiofemoral joint space in knee osteoarthritis - Its reliability, sensitivity to change, and longitudinal validity
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DOI：
10.1002/art.21374
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发表时间：
2005-11-01
影响因子：
--
通讯作者：
Felson, DT
中科院分区：
文献类型：
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作者：
LaValley, MP;McLaughlin, S;Felson, DT
目标。评价侧位片对胫股变窄变化的信度、效度和敏感性。在一项症状性膝骨关节炎（OA）的自然史研究中，在基线和30个月时获得膝关节侧位片和透视定位后前位（PA）半屈位片，均为30度屈曲和负重。使用重复x线片评估重测可靠性，使用电子卡尺测量关节间隙宽度。所有x线片评分为0-3分，关节间隙损失的进展定义为关节间隙缩小1级。我们比较了PA视图对变化的敏感性。我们通过检查进展的膝关节是否在全肢影像上显示预期的错位来评估有效性。侧位片对TF关节间隙的重测信度的均方根误差为0.303 mm，重复次数在1 mm以内的概率为92.5%。单侧位片（n = 41）比单侧位片（n = 27）显示膝关节进展。与无关节间隙丧失的膝关节相比，仅内侧筋膜室丧失的膝关节外侧视野内翻错位较多（P < 0.001），外侧筋膜室丧失的膝关节外侧视野内翻错位较多（P = 0.008）。在评估TF关节间隙损失时，侧位x线片是可靠、有效的，并且比透视定位的PA x线片对变化更敏感。
Objective. To evaluate the reliability, validity, and sensitivity to change of tibiofemoral (TF) narrowing on lateral radiographic views.Methods. In a natural history study of symptomatic knee osteoarthritis (OA), both lateral view and fluoroscopically positioned posteroanterior (PA) semiflexed view radiographs of the knee in 30 degrees of flexion and with weight bearing were obtained at baseline and at 30 months. Test-retest reliability was evaluated using repeat radiographs, with joint space width measured using electronic calipers. All radiographs were scored on a 0-3 scale, and progression of joint space loss was defined as narrowing of the joint space by 1 grade. We evaluated sensitivity to change compared with the PA view. We evaluated validity by examining whether knees with progression showed expected malalignment on full-limb films.Results. Test-retest reliability of the TF joint space using the lateral view had a root mean square error of 0.303 mm, with 92.5% of repeats within I mm. More knees showed progression on the lateral view alone (n = 41) than on the PA view alone (n = 27). Compared with knees without joint space loss, knees with medial compartment loss on the lateral view only were more varus malaligned (P < 0.001), while those with lateral compartment loss were more valgus malaligned (P = 0.008).Conclusion. In the assessment of TF joint space loss, lateral view radiographs are reliable, valid, and more sensitive to change than fluoroscopically positioned PA radiographs.