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The diagnostic performance of radiography for detection of osteoarthritis-associated features compared with MRI in hip joints with chronic pain

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Abstract

Objective

To evaluate the diagnostic performance of radiography for the detection of MRI-detected osteoarthritis-associated features in various articular subregions of the hip joint.

Materials and methods

Forty-four patients with chronic hip pain (mean age, 63.3 ± 9.5 years), who were part of the Hip Osteoarthritis MRI Scoring (HOAMS) cohort, underwent both weight-bearing anteroposterior pelvic radiography and 1.5 T MRI. The HOAMS study was a prospective observational study involving 52 subjects, conducted to develop a semiquantitative MRI scoring system for hip osteoarthritis features. In the present study, eight subjects were excluded because of a lack of radiographic assessment. On radiography, the presence of superior and medial joint space narrowing, superior and inferior acetabular/femoral osteophytes, acetabular subchondral cysts, and bone attrition of femoral head was noted. On MRI, cartilage, osteophytes, subchondral cysts, and bone attrition were evaluated in the corresponding locations. Diagnostic performance of radiography was compared with that of MRI, and the area under curve (AUC) was calculated for each pathological feature.

Results

Compared with MRI, radiography provided high specificity (0.76–0.90) but variable sensitivity (0.44–0.78) for diffuse cartilage damage (using JSN as an indirect marker), femoral osteophytes, acetabular subchondral cysts and bone attrition of the femoral head, and a low specificity (0.42 and 0.58) for acetabular osteophytes. The AUC of radiography for detecting overall diffuse cartilage damage, marginal osteophytes, subchondral cysts and bone attrition was 0.76, 0.78, 0.67, and 0.82, respectively.

Conclusions

Diagnostic performance of radiography is good for bone attrition, fair for marginal osteophytes and cartilage damage, but poor for subchondral cysts.

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Abbreviations

OA:

Osteoarthritis

OARSI:

Osteoarthritis Research Society International

ACR:

American College of Rheumatology

JSN:

Joint space narrowing

TR:

Repetition time

TE:

Echo time

FOV:

Field of view

PDw:

Proton density-weighted

FS:

Fat-suppressed

SE:

Spin echo

HOAMS:

Hip osteoarthritis MRI scoring

References

  1. Zhang W, Doherty M. EULAR recommendations for knee and hip osteoarthritis: a critique of the methodology. Br J Sports Med. 2006;40:664–9.

    Article  PubMed  CAS  Google Scholar 

  2. Felson DT, Zhang Y. An update on the epidemiology of knee and hip osteoarthritis with a view to prevention. Arthritis Rheum. 1998;41:1343–55.

    Article  PubMed  CAS  Google Scholar 

  3. Hoaglund FT, Steinbach LS. Primary osteoarthritis of the hip: etiology and epidemiology. J Am Acad Orthop Surg. 2001;9:320–7.

    PubMed  CAS  Google Scholar 

  4. Fortin PR, Clarke AE, Joseph L, et al. Outcomes of total hip and knee replacement: preoperative functional status predicts outcomes at six months after surgery. Arthritis Rheum. 1999;42:1722–8.

    Article  PubMed  CAS  Google Scholar 

  5. Altman R, Alarcon G, Appelrouth D, et al. The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hip. Arthritis Rheum. 1991;34:505–14.

    Article  PubMed  CAS  Google Scholar 

  6. Gossec L, Paternotte S, Bingham 3rd CO, et al. OARSI/OMERACT initiative to define states of severity and indication for joint replacement in hip and knee osteoarthritis. An OMERACT 10 Special Interest Group. J Rheumatol. 2011;38:1765–9.

    Article  PubMed  Google Scholar 

  7. Altman RD, Gold GE. Atlas of individual radiographic features in osteoarthritis, revised. Osteoarthr Cartil. 2007;15(Suppl A):A1–A56.

    Article  PubMed  Google Scholar 

  8. Wright AA, Cook C, Abbott JH. Variables associated with the progression of hip osteoarthritis: a systematic review. Arthritis Rheum. 2009;61:925–36.

    Article  PubMed  Google Scholar 

  9. Jacobsen S, Sonne-Holm S, Soballe K, Gebuhr P, Lund B. The relationship of hip joint space to self reported hip pain. A survey of 4.151 subjects of the Copenhagen City Heart Study: the Osteoarthritis Substudy. Osteoarthr Cartil. 2004;12:692–7.

    Article  PubMed  Google Scholar 

  10. Hayashi D, Xu L, Roemer FW, et al. Detection of osteophytes and subchondral cysts in the knee with use of tomosynthesis. Radiology. 2012;263:206–15.

    Article  PubMed  Google Scholar 

  11. Guermazi A, Hunter DJ, Roemer FW. Plain radiography and magnetic resonance imaging diagnostics in osteoarthritis: validated staging and scoring. J Bone Joint Surg Am. 2009;91 Suppl 1:54–62.

    Article  PubMed  Google Scholar 

  12. Hunter DJ, Arden N, Conaghan PG, et al. Definition of osteoarthritis on MRI: results of a Delphi exercise. Osteoarthr Cartil. 2011;19:963–9.

    Article  PubMed  CAS  Google Scholar 

  13. Roemer FW, Hunter DJ, Winterstein A, et al. Hip Osteoarthritis MRI Scoring System (HOAMS): reliability and associations with radiographic and clinical findings. Osteoarthr Cartil. 2011;19:946–62.

    Article  PubMed  CAS  Google Scholar 

  14. Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis. 1957;16:494–502.

    Article  PubMed  CAS  Google Scholar 

  15. Wiberg G. Studies on dysplastic acetabula and congenital subluxation of the hip joint. Acta Chir Scand. 1939;83 Suppl 58:5–135.

    Google Scholar 

  16. Werner CM, Ramseier LE, Ruckstuhl T, et al. Normal values of Wiberg’s lateral center-edge angle and Lequesne’s acetabular index–a coxometric update. Skeletal Radiol. 2012;41:1273–8.

    Article  PubMed  Google Scholar 

  17. Tape TG (Accessed March 20, 2012.) The area under an ROC curve. Interpreting diagnostic tests. University of Nebraska Medical Center. Available at: http://gim.unmc.edu/dxtests/Default.htm

  18. Hunter DJ, Zhang YQ, Tu X, et al. Change in joint space width: hyaline articular cartilage loss or alteration in meniscus? Arthritis Rheum. 2006;54:2488–95.

    Article  PubMed  CAS  Google Scholar 

  19. Vignon E, Conrozier T, Piperno M, Richard S, Carrillon Y, Fantino O. Radiographic assessment of hip and knee osteoarthritis. Recommendations: recommended guidelines. Osteoarthr Cartil. 1999;7:434–6.

    Article  PubMed  CAS  Google Scholar 

  20. Amin S, LaValley MP, Guermazi A, et al. The relationship between cartilage loss on magnetic resonance imaging and radiographic progression in men and women with knee osteoarthritis. Arthritis Rheum. 2005;52:3152–9.

    Article  PubMed  Google Scholar 

  21. Goker B, Sancak A, Haznedaroglu S, Arac M, Block JA. The effects of minor hip flexion, abduction or adduction and X-ray beam angle on the radiographic joint space width of the hip. Osteoarthr Cartil. 2005;13:379–86.

    Article  PubMed  Google Scholar 

  22. Guermazi A, Roemer FW, Burstein D, Hayashi D. Why radiography should no longer be considered a surrogate outcome measure for longitudinal assessment of cartilage in knee osteoarthritis. Arthritis Res Ther. 2011;13:247.

    Article  PubMed  Google Scholar 

  23. Chan WP, Lang P, Stevens MP, et al. Osteoarthritis of the knee: comparison of radiography, CT, and MR imaging to assess extent and severity. AJR Am J Roentgenol. 1991;157:799–806.

    Article  PubMed  CAS  Google Scholar 

  24. Poleksic L, Zdravkovic D, Jablanovic D, Watt I, Bacic G. Magnetic resonance imaging of bone destruction in rheumatoid arthritis: comparison with radiography. Skeletal Radiol. 1993;22:577–80.

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

The authors would like to thank all the participants in this study for their time and efforts. We thank the staff of the Department of Radiology, Klinikum Augsburg, Germany for their support in image acquisition. We further wish to acknowledge the staff and management team at the “Private Practice for Musculoskeletal MRI”, Stadtbergen, Germany, who supported the HOAMS study. We thank Michael Ecker, Department of Orthopedic and Trauma Surgery, Klinikum Augsburg, for his support of patient coordination and for his valuable clinical input.

Funding source

The HOAMS study was supported by a grant of the “Private Practice for Musculoskeletal MRI”, Ulmer Landstr. 350, 86391 Stadtbergen, Germany. The funding source did not play any 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.

Disclosure

This study used data from the HOAMS study, and thus share the same cohort characteristics as those reported in our previous publication [Roemer FW et al. (2011), Osteoarthritis Cartilage 19:946–962]. However, what we reported in the present study does not overlap with any analytic results in our previous publication.

Conflict of interests

The third author is the President of Boston Imaging Core Lab (BICL), LLC and is a consultant to Genzyme, Stryker, Merck Serono, Novartis and Astra Zeneca. The 4th author is supported by an Australia Research Council (ARC) Future Fellowship and receives research or institutional support from ARC, NIH, and NHMRC. The senior author is CMO of BICL and is a consultant to MerckSerono and National Institute of Health. The 7th author is part of the Management Team of BICL (European Operation)

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Authors and Affiliations

  1. Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, FGH Building 3rd Floor, 820 Harrison Avenue, Boston, MA, 02118, USA

    Li Xu, Daichi Hayashi, Ali Guermazi & Frank W. Roemer

  2. Department of Radiology, Beijing Jishuitan Hospital, Beijing, 100035, China

    Li Xu

  3. Department of Medicine, University of Sydney, Sydney, Australia

    David J. Hunter

  4. Division of Research, New England Baptist Hospital, Boston, MA, 02120, USA

    Ling Li

  5. Department of Radiology, Klinikum Augsburg, Augsburg, Germany

    Anton Winterstein, Klaus Bohndorf & Frank W. Roemer

  6. Department of Radiology, University of Erlangen, Erlangen, Germany

    Frank W. Roemer

Authors
  1. Li Xu
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  2. Daichi Hayashi
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  3. Ali Guermazi
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  4. David J. Hunter
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  5. Ling Li
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  6. Anton Winterstein
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  7. Klaus Bohndorf
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  8. Frank W. Roemer
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Corresponding author

Correspondence to Frank W. Roemer.

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Xu, L., Hayashi, D., Guermazi, A. et al. The diagnostic performance of radiography for detection of osteoarthritis-associated features compared with MRI in hip joints with chronic pain. Skeletal Radiol 42, 1421–1428 (2013). https://doi.org/10.1007/s00256-013-1675-7

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  • DOI: https://doi.org/10.1007/s00256-013-1675-7

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