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Test–retest reliability of tibiofemoral joint space width measurements made using a low-dose standing CT scanner

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Abstract

Objective

To determine the test–retest reliability of knee joint space width (JSW) measurements made using standing CT (SCT) imaging.

Subjects and methods

This prospective two-visit study included 50 knees from 30 subjects (66% female; mean ± SD age 58.2 ± 11.3 years; BMI 29.1 ± 5.6 kg/m2; 38% KL grade 0–1). Tibiofemoral geometry was obtained from bilateral, approximately 20° fixed-flexed SCT images acquired at visits 2 weeks apart. For each compartment, the total joint area was defined as the area with a JSW <10 mm. The summary measurements of interest were the percentage of the total joint area with a JSW less than 0.5-mm thresholds between 2.0 and 5.0 mm in each tibiofemoral compartment. Test–retest reliability of the summary JSW measurements was assessed by intraclass correlation coefficients (ICC 2,1) for the percentage area engaged at each threshold of JSW and root-mean-square errors (RMSE) were calculated to assess reproducibility.

Results

The ICCs were excellent for each threshold assessed, ranging from 0.95 to 0.97 for the lateral and 0.90 to 0.97 for the medial compartment. RMSE ranged from 1.1 to 7.2% for the lateral and from 3.1 to 9.1% for the medial compartment, with better reproducibility at smaller JSW thresholds.

Conclusion

The knee joint positioning protocol used demonstrated high day-to-day reliability for SCT 3D tibiofemoral JSW summary measurements repeated 2 weeks apart. Low-dose SCT provides a great deal of information about the joint while maintaining high reliability, making it a suitable alternative to plain radiographs for evaluating JSW in people with knee OA.

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Acknowledgements

The investigators appreciate the support of Ms Maria Davis Hochstedler and Mr Tom Baer for their help in facilitating key aspects of this research.

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Authors and Affiliations

  1. Department of Rehabilitation Medicine, University of Kansas Medical Center, 3901 Rainbow Boulevard, Mailstop 1046, Kansas City, KS, 66160, USA

    Neil A. Segal

  2. The University of Iowa, Iowa City, IA, USA

    Neil A. Segal, John Bergin, Andrew Kern & Christian Findlay

  3. Department of Orthopaedics and Rehabilitation, The University of Iowa, Iowa City, IA, USA

    Donald D. Anderson

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  1. Neil A. Segal
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  2. John Bergin
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  3. Andrew Kern
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  4. Christian Findlay
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Corresponding author

Correspondence to Neil A. Segal.

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Funding

This work was supported by a National Heart, Lung, and Blood Institute grant (T35HL007485). The sponsor played no role in the study design, collection, analysis, and interpretation of data; in the writing of the manuscript; or in the decision to submit the manuscript for publication. Research reported in this manuscript was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health under award number P50AR055533. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Conflicts of interest

The corresponding author is named as an inventor on a patent application for the positioning frame used in this study, but has neither intellectual property rights nor financial rights to that patent and has neither been employed nor received honoraria, stock options, or other sources of financial support in relation to this work. The other authors report no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Segal, N.A., Bergin, J., Kern, A. et al. Test–retest reliability of tibiofemoral joint space width measurements made using a low-dose standing CT scanner. Skeletal Radiol 46, 217–222 (2017). https://doi.org/10.1007/s00256-016-2539-8

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  • DOI: https://doi.org/10.1007/s00256-016-2539-8

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