A Decision Support System for the Automatic Assessment of Hip Osteoarthritis Severity by Hip Joint Space Contour Spectral Analysis

  • Ioannis Boniatis
  • Dionisis Cavouras
  • Lena Costaridou
  • Ioannis Kalatzis
  • Elias Panagiotopoulos
  • George Panayiotakis
Part of the Lecture Notes in Computer Science book series (LNCS, volume 4345)


A decision support system was developed for the grading of hip osteoarthritis (OA) severity. Sixty four hips (18 normal, 46 osteoarthritic) were studied from the digitized radiographs of 32 patients with unilateral or bilateral hip-OA. Hips were allocated into three OA-severity categories, formed accordingly to the Kellgren and Lawrence scale: “Normal”, “Mild-Moderate”, and “Severe”. Employing custom developed algorithms: (i) the radiographic contrast was enhanced, (ii) 64 ROIs, corresponding to patients’ radiographic Hip Joint Spaces (HJSs), were determined, and (iii) Fourier descriptors of the HJS-ROIs boundary were generated. These descriptors were used in the design of a two-level hierarchical decision tree structure, employed for the discrimination of the OA-severity categories. The overall classification accuracies accomplished by the system, regarding the discrimination between: (i) Normal and osteoarthritic hips, and (ii) hips of “Mild-Moderate” OA and of “Severe” OA were 92.2% and 86.0%, respectively. The proposed system may contribute to osteoarthritic patients management.


Decision Support System Fourier Descriptor Pelvic Radiograph Automatic Assessment Discrete Fourier Trans 
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  1. 1.
    Hinton, R., Moody, R.L., Davis, A.W., Thomas, S.F.: Osteoarthritis: Diagnosis and Therapeutic Considerations. Am. Fam. Physician 65, 841–848 (2002)Google Scholar
  2. 2.
    Iannone, F., Lapadula, G.: The Pathophysiology of Osteoarthritis. Aging Clin. Exp. Res. 15, 364–372 (2003)Google Scholar
  3. 3.
    Peterfy, C.G.: Imaging of the Disease Process. Curr. Opin. Rheumatol 14, 590–596 (2002)CrossRefGoogle Scholar
  4. 4.
    Ory, P.A.: Radiography in the Assessment of Musculoskeletal Conditions. Best. Pract. Res. Clin. Rheumatol 17, 495–512 (2003)CrossRefGoogle Scholar
  5. 5.
    Altman, R.D., Fries, J.F., Bloch, D.A., et al.: Radiographic Assessment of Progression in Osteoarthritis. Arthritis Rheum 30, 1214–1225 (1987)CrossRefGoogle Scholar
  6. 6.
    Sun, Y., Günther, K.P., Brenner, H.: Reliability of Radiographic Grading of Osteoarthritis of the Hip and Knee. Scand. J. Rheumatol 26, 155–165 (1997)CrossRefGoogle Scholar
  7. 7.
    Kellgren, J.H., Lawrence, J.S.: Radiological Assessment of Osteoarthrosis. Ann. Rheum. Dis. 16, 494–501 (1957)CrossRefGoogle Scholar
  8. 8.
    Spector, T.D., Cooper, C.: Radiographic Assessment of Osteoarthritis in Population Studies: Whither Kellgren and Lawrence? Osteoarthritis Cartilage 1, 203–206 (1993)CrossRefGoogle Scholar
  9. 9.
    Croft, P., Cooper, C., Wickham, C., Coggon, D.: Defining Osteoarthritis of the Hip for Epdemiologic Studies. Am. J. Epidemiol. 132, 514–522 (1990)Google Scholar
  10. 10.
    Ingvarsson, T., Hägglund, G., Lindberg, H., Lohmander, L.S.: Assessment of Primary Osteoarthritis: Comparison of Radiographic Methods Using Colon Radiographs. Ann. Rheum. Dis. 59, 650–653 (2000)CrossRefGoogle Scholar
  11. 11.
    Boniatis, I., Costaridou, L., Cavouras, D., Panagiotopoulos, E., Panayiotakis, G.: Quantitative Assessment of Hip Osteoarthritis Based on Image Texture Analysis. Br. J. Radiol. 79, 232–238 (2006)CrossRefGoogle Scholar
  12. 12.
    Boniatis, I., Costaridou, L., Cavouras, D., Kalatzis, I., Panagiotopoulos, E., Panayiotakis, G.: Assessing Hip Osteoarthritis Severity Utilizing a Probabilistic Neural Network Based Classification Scheme. Med. Eng. Phys. (in Press)Google Scholar
  13. 13.
    Boniatis, I., Costaridou, L., Cavouras, D., Kalatzis, I., Panagiotopoulos, E., Panayiotakis, G.: Osteoarthritis Severity of the Hip by Computer-Aided Grading of Radiographic Images. Med. Bio. Eng. Comput. (in Press)Google Scholar
  14. 14.
    Boniatis, I., Costaridou, L., Cavouras, D., Panagiotopoulos, E., Panayiotakis, G.: A Computer-Based Image Analysis Method for Assessing the Severity of Hip Joint Osteoarthritis. Nucl. Instrum. Meth. A. (in Press)Google Scholar
  15. 15.
    Altman, R., Alarcón, G., Appelrouth, D., et al.: The American College of Rheumatology Criteria for the Classification and Reporting of Osteoarthritis of the Hip. Arthritis Rheum 34, 505–514 (1991)CrossRefGoogle Scholar
  16. 16.
    Lumiscan 75, system specifications. Lumisys Inc. (1998),
  17. 17.
    Sakellaropoulos, P., Costaridou, L., Panayiotakis, G.: A Wavelet Based Spatially Adaptive Method for Mammographic Contrast Enhancement. Phys. Med. Biol. 48, 787–803 (2003)CrossRefGoogle Scholar
  18. 18.
    Sakellaropoulos, P., Costaridou, L., Panayiotakis, G.: An Image Visualisation Tool in Mammography. Med. Inform. Internet. Med. 24, 53–73 (1999)CrossRefGoogle Scholar
  19. 19.
    Sakellaropoulos, P., Costaridou, L., Panayiotakis, G.: Using Component Technologies for Web – Based Wavelet Enhanced Mammographic Image Visualization. Med. Inform. Internet Med. 25, 171–181 (2000)CrossRefGoogle Scholar
  20. 20.
    Conrozier, T., Tron, A.M., Balblanc, J.C., et al.: Measurement of the Hip Joint Space Using Computerized Image Analysis. Rev. Rhum. Engl. Ed. 60, 105–111 (1993)Google Scholar
  21. 21.
    Rangayyan, R.M.: Biomedical image analysis. CRC Press LLC, Boca Raton (2005)Google Scholar
  22. 22.
    Gonzalez, R.C., Woods, R.E.: Digital Image Processing, 2nd edn. Prentice Hall, Inc., New Jersey (2002)Google Scholar
  23. 23.
    Gupta, L., Srinath, M.D.: Contour Sequence Moments for the Classification of Closed Planar Shapes. Pattern Recognition 20, 267–272 (1987)CrossRefGoogle Scholar
  24. 24.
    Ahmed, N., Rao, K.R.: Orthogonal Transforms for Digital Signal Processing. Springer, Heidelberg (1975)zbMATHGoogle Scholar
  25. 25.
    Theodoridis, S., Koutroumbas, K.: Pattern Recognition, 2nd edn. Elsevier Academic Press, Amsterdam (2003)Google Scholar
  26. 26.
    van Belle, G., Fisher, L.D., Heagerty, P.J., Lumley, T.: Biostatistics. A methodology for the health sciences, 2nd edn. Wiley-Interscience, New Jersey (2004)zbMATHGoogle Scholar

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© Springer-Verlag Berlin Heidelberg 2006

Authors and Affiliations

  • Ioannis Boniatis
    • 1
  • Dionisis Cavouras
    • 2
  • Lena Costaridou
    • 1
  • Ioannis Kalatzis
    • 2
  • Elias Panagiotopoulos
    • 3
  • George Panayiotakis
    • 1
  1. 1.School of Medicine, Department of Medical PhysicsUniversity of PatrasPatrasGreece
  2. 2.Department of Medical Instrumentation TechnologyTechnological Institute of AthensAthensGreece
  3. 3.School of Medicine, Department of OrthopaedicsUniversity of PatrasPatrasGreece

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