European Radiology

, Volume 14, Issue 5, pp 865–869 | Cite as

Are digital images good enough? A comparative study of conventional film-screen vs digital radiographs on printed images of total hip replacement

  • K. EklundEmail author
  • K. Jonsson
  • G. Lindblom
  • B. Lundin
  • J. Sanfridsson
  • M. Sloth
  • B. Sivberg


The aim of this study was to evaluate the inter- and intra-observer variability and to find differences in diagnostic safety between digital and analog technique in diagnostic zones around hip prostheses. In 80 patients who had had a total hip replacement (THR) for more than 2 years, a conventional image and a digital image were taken. Gruen’s model of seven distinct regions of interest was used for evaluations. Five experienced radiologists observed the seven regions and noted in a protocol the following distances: stem–cement; cement–bone; and stem–bone. All images were printed on hard copies and were read twice. Weighted kappa, κw, analyses were used. The two most frequently loosening regions, stem–cement region 1 and cement–bone region 7, were closely analyzed. In region 1 the five observers had an agreement of 86.75–97.92% between analog and digital images in stem–cement, which is a varied κw 0.29–0.71. For cement–bone region 7 an agreement of 87.21–90.45% was found, which is a varied κw of 0.48–0.58. All the kappa values differ significantly from nil. The result shows that digital technique is as good as analog radiographs for diagnosing possible loosening of hip prostheses.


Digital radiographs Analog radiographs Total hip replacement Comparative study 



The authors thank P.-E. Isberg, Department of Statistics, Lund University, for help with the statistics.


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Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  • K. Eklund
    • 1
    Email author
  • K. Jonsson
    • 1
  • G. Lindblom
    • 1
  • B. Lundin
    • 1
  • J. Sanfridsson
    • 1
  • M. Sloth
    • 1
  • B. Sivberg
    • 2
  1. 1.Department of RadiologyCenter for Medical Imaging and Physiology, Lund University HospitalLundSweden
  2. 2.Department of Nursing, Faculty of MedicineLund UniversityLundSweden

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