European Radiology

, Volume 14, Issue 9, pp 1568–1573

Fixed-flexion radiography of the knee provides reproducible joint space width measurements in osteoarthritis

  • Manish Kothari
  • Ali Guermazi
  • Gabriele von Ingersleben
  • Yves Miaux
  • Martine Sieffert
  • Jon E. Block
  • Randall Stevens
  • Charles G. Peterfy
Musculoskeletal

DOI: 10.1007/s00330-004-2312-6

Cite this article as:
Kothari, M., Guermazi, A., von Ingersleben, G. et al. Eur Radiol (2004) 14: 1568. doi:10.1007/s00330-004-2312-6

Abstract

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 10° 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.

Keywords

KneeOsteoarthritisRadiographyJoint space width

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Manish Kothari
    • 1
  • Ali Guermazi
    • 2
  • Gabriele von Ingersleben
    • 2
  • Yves Miaux
    • 2
  • Martine Sieffert
    • 1
  • Jon E. Block
    • 1
  • Randall Stevens
    • 3
  • Charles G. Peterfy
    • 1
  1. 1.Department of Scientific Client ServicesSynarc, Inc.San FranciscoUSA
  2. 2.Department of Reading ServicesSynarc, Inc.San FranciscoUSA
  3. 3.Hoffmann-La RocheNutleyUSA