Evaluation of the ‘Lequesne’s false profile’ of the hip in patients with hip osteoarthritis (original) (raw)
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Arthritis research & therapy, 2005
Joint space width (JSW) and narrowing (JSN) measurements on radiographs are currently the best way to assess disease severity or progression in hip osteoarthritis, yet we lack data regarding the most accurate and sensitive measurement technique. This study was conducted to determine the optimal radiograph and number of readers for measuring JSW and JSN. Fifty pairs of radiographs taken three years apart were obtained from patients included in a structure modification trial in hip osteoarthritis. Three radiographs were taken with the patient standing: pelvis, target hip anteroposterior (AP) and oblique views. Two trained readers, blinded to each other's findings, time sequence and treatment, each read the six radiographs gathered for each patient twice (time interval > or = 15 days), using a 0.1 mm graduated magnifying glass. Radiographs were randomly coded for each reading. The interobserver and intraobserver cross-sectional (M0 and M36) and longitudinal (M0-M36) reproducibil...
Osteoarthritis and Cartilage, 2009
Objective: The objective of this work was to compare the measurement properties of three categorical X-ray scoring methods for hip osteoarthritis (OA). Methods: In data obtained from trials and cohorts, radiographs were evaluated using the Kellgren and Lawrence (KL) grading system, the Osteoarthritis Research Society International (OARSI) joint space narrowing score, and quantitative measurement of joint space width (JSW), analysed as a categorical variable according to Croft and Lane's cutoffs (1.5, 2.5 and 3 mm). Predictive validity was assessed through logistic regression to predict joint replacement in one database. Construct validity was assessed through logistic regression between pain and function and X-ray stages. Inter-observer and intra-observer reliability were assessed in 50 subjects by weighted kappa. Sensitivity to change was assessed in 50 patients over a 24-month interval, by standardized response mean (SRM). Results: Radiographs were available from one trial and two cohorts (1404 X-rays). All three methods predicted joint replacement in the trial. Correlation with clinical parameters was low for the three scoring methods, except for the single community-based cohort. Interrater reliability was higher for categorical JSW (kappa, 0.71 vs 0.44 and 0.47 for KL and OARSI, respectively). Intrarater reliability was similar for the three methods (0.79 vs 0.69 and 0.81). Sensitivity to change was higher for categorical JSW than KL and OARSI (SRM, 0.77 vs 0.28 and 0.35). Conclusion: Categorical JSW has similar validity and higher sensitivity to change than the other categorical scoring techniques in hip OA. These results indicate categorical JSW may be the preferred method to evaluate structural severity in hip OA clinical trials.
Annals of The Rheumatic Diseases, 1996
Objectives-To determine a cut off value for changes in radiological joint space width that allowed definition of radiological progression of hip osteoarthritis not related to measurement method errors and, thereafter, to determine factors predictive of radiological progression of hip osteoarthritis and to evaluate the correlations between clinical and radiological parameters. Methods-A prospective, longitudinal (one year duration), multicentre study was made of patients with osteoarthritis of the hip (American College of Rheumatology criteria). Data on clinical activity (pain, functional impairment), demographic data (age, gender, body mass index), and femoral head migration (superolateral, superomedial, concentric) were collected when the patient entered the study; radiological grade (joint space width in millimetres at the narrowest point using a 0 1 mm graduated magnifying glass, evaluated by a single observer unaware of the chronology of the films) was recorded at the patient's entry to the study and after one year.
Annals of The Rheumatic Diseases, 1998
Objective-To assess the eVect of standing position on joint space width (JSW) measurements of the hips with and without osteoarthritis (OA) on pelvic radiographs. Methods-Adult patients aged 18 or more had pelvic anteroposterior conventional radiographs standing and supine performed by a single radiologist in the same radiology unit according to standardised guidelines. JSW measurements in mm were made by a single reader blind to patients' identity and type of view, using a 0.1 mm graduated magnifying glass directly laid over the radiograph, at the narrowest point for OA hips or at the vertical joint space for non-OA hips. Agreement of JSW between both views was assessed using the Bland and Altman graphical analysis. Results-JSW was greater on standing than supine radiographs, for example, 7.1% for OA hips. Mean (SD) diVerences and limits of agreement (mm) between both views were 0.08 (0.27) and −0.46 to 0.62 for the 70 non-OA hips, 0.02 (0.31) and −0.60 to 0.64 for the 46 OA hips. Corresponding 95% confidence intervals of mean diVerences were 0.02, −0.14 mm and −0.07, −0.11 mm. Conclusions-Measurements of JSW of the hip on pelvic standing and supine radiographs are concordant. Changes less than or equal to 0.64 mm between the two views are similar or inferior to radiological progression of OA.
The Journal of rheumatology, 2002
To compare the intraobserver reliability and the sensitivity to change of 2 techniques evaluating the cartilage breakdown in hip osteoarthritis (OA). 3 year longitudinal study. patients with painful hip OA. coxofemoral joint space width (JSW) at baseline and at 3 year followup was measured on anteroposterior weight-bearing radiographs by 2 methods: a manual method to obtain JSW at the narrowest point (minimal JSW) using a 0.1 mm graduated magnifying glass and a computer based method to obtain minimal and average JSW. Two assessments, at one month interval, of each pair of films; evaluation of the intraobserver reliability using the intraclass coefficient of correlation, and the Bland and Altman approach, obtaining the smallest detectable difference (SDD). For each technique, percentage of progressors was evaluated, i.e., the percentage of patients with change greater than the SDD. Evaluation of sensitivity to change was performed using the standardized response mean (SRM), with 95% ...
The effects of position on the radiographic joint space in osteoarthritis of the hip
Osteoarthritis and Cartilage, 1997
The aim of the study was to assess whether radiographm hip joint space thickness was changed by weight-bearing (WB) compared with non wmght-bearmg (NWB) potation, and to evaluate whether radiographs centered on the hip were more senmtlve than pelvic X-rays to detect such a change. Anteropostermr radiographs of the pelvis were made in 30 patients with hip osteoarthmtis OA (46 OA and 11 normal hips). Osteoarthrmc, as well as contralateral normal hips, were analyzed Radiographs centered on OA hip were performed in 28 other patients X-rays were made in WB and NWB positions using a standardized radlologmal procedure. Measurements of mean joint space width (MeanJSW), maximum joint space narrowing (MaxJSN) and joint space surface area (JSA), were made using a computerized image analysis system The joint space width was unaffected by WB m normal joints but decreased with WB in OA joints. The decrease was mgnlficant only when considering MaxJSN in patients with a joint space thickness smaller than 2.5mm. The difference between WB and NWB was larger in radiographs centered on the hip than on pelvic X-rays. MeanJSW and JSA were found to be less senmtlve than MaxJSN. The decrease of joint space width was reversely correlated with joint space size m WB. These results suggest that WB radiographs of the hip should be used m preference to NWB in studies of hip OA
Radiographic assessment of hip and knee osteoarthritis. Recommendations: recommended guidelines
Osteoarthritis and Cartilage, 1999
Pathological lesions of osteoarthritis, demonstrated by conventional radiography, can be assessed by scoring systems and/or measurement with a quite acceptable reproducibility. Scores are recommended for a rough staging of osteoarthritis and of bone changes. Measurement is recommended for assessment of joint space narrowing progression. A good assessment of progression implicates a perfect reproducibility of the radiographic image of the joint. Accuracy of standard radiograph is improved by some views such as the hip profile and the schuss view.
Arthritis Res …, 2005
Joint space width (JSW) and narrowing (JSN) measurements on radiographs are currently the best way to assess disease severity or progression in hip osteoarthritis, yet we lack data regarding the most accurate and sensitive measurement technique. This study was conducted to determine the optimal radiograph and number of readers for measuring JSW and JSN. Fifty pairs of radiographs taken three years apart were obtained from patients included in a structure modification trial in hip osteoarthritis. Three radiographs were taken with the patient standing: pelvis, target hip anteroposterior (AP) and oblique views. Two trained readers, blinded to each other's findings, time sequence and treatment, each read the six radiographs gathered for each patient twice (time interval ≥15 days), using a 0.1 mm graduated magnifying glass. Radiographs were randomly coded for each reading. The interobserver and intraobserver cross-sectional (M0 and M36) and longitudinal (M0-M36) reproducibilities were assessed using the intraclass coefficient (ICC) and Bland-Altman method for readers 1 and 2 and their mean. Sensitivity to change was estimated using the standardized response mean (SRM = change/standard deviation of change) for M0-M36 changes. For interobserver reliability on M0-M36 changes, the ICCs (95% confidence interval [CI]) were 0.79 (0.65-0.88) for pelvic view, 0.87 (0.78-0.93) for hip AP view and 0.86 (0.76-0.92) for oblique view. Intraobserver reliability ICCs were 0.81 (0.69-0.89) for observer 1 and 0.97 (0.95-0.98) for observer 2 for the pelvic view; 0.87 (0.78-0.92) and 0.97 (0.96-0.99) for the hip AP view; and 0.73 (0.57-0.84) and 0.93 (0.88-0.96) for the oblique view. SRMs were 0.61 (observer 1) and 0.82 (observer 2) for pelvic view; 0.64 and 0.75 for hip AP view; and 0.77 and 0.70 for oblique view. All three views yielded accurate JSW and JSN. According to the best reader, the pelvic view performed slightly better. Both readers exhibited high precision, with SRMs of 0.6 or greater for assessing JSN over three years. Selecting a single reader was the most accurate method, with 0.3 mm precision. Using this cutoff, 50% of patients were classified as 'progressors'. AP = anteroposterior; CI = confidence interval; ICC = intraclass coefficient of correlation; JSN = joint space narrowing; JSW = joint space width; OA = osteoarthritis; SD = standard deviation; SDD = smallest detectable difference; SRM = standardized response mean; WOMAC = Western and Ontario MacMaster University.