Automatic Quantification of Radiographic Finger Joint Space Width of Patients With Early Rheumatoid Arthritis

Abstract

The assessment of joint space width (JSW) on hand X-ray images of patients suffering from rheumatoid arthritis (RA) is a time-consuming task. Manual assessment is semiquantitative and is observer dependent which hinders an accurate evaluation of joint damage, particularly in the early stages. Automated analysis of the JSW is an important step forward since it is observer independent and might improve the assessment sensitivity in the early RA stage. This study proposes a fully automatic method for both joint location and margin detection in RA hand radiographs. The location detection procedure is based on image features of the joint region and is aided by geometric relationship of finger joints. More than 99% of joint locations are detected with an error smaller than 3 mm with respect to the manually indicated gold standard. The joint margins are detected by combining intensity values and spatially constrained intensity derivatives, refined by an active contour model. More than 96% of the joints are successfully delineated. The JSW is calculated over the middle 60% of a landmark-defined joint span. The overall JSW error compared with the ground truth is 6.8%. In conclusion, the proposed method is able to automatically locate the finger joints in RA hand radiographs, and to quantify the JSW of these joints.

Computer-Based Radiographic Quantification of Joint Space Narrowing Progression Using Sequential Hand Radiographs: Validation Study in Rheumatoid Arthritis Patients from Multiple Institutions

“…Accurate estimate of JSN is important in clinical trials and daily clinical routine because cartilage degradation, which can be visualized radiographically as JSN, is a surrogate parameter for outcome in RA [27]. Although various software applications have been introduced to measure JSW quantitatively with high reproducibility, the definition of the bony margin for JSW measurement depends on the designer of the computer-based method [14]. To address these issues, we established a computer-based method that can quantify JSN progression using superimposed sequential radiographs while eliminating the process of contouring the distal margins of MCP joints that is ambiguous on radiographs.…”

“…On the other hand, Pfeil et al used an edge-based approach to detect the edges of the two specified bones by filtering within a region of interest (ROI), and measuring JSW [8]. Since a radiograph is a two-dimensional projection of a three-dimensional structure, the definition of the joint margin i s a m b i g u o u s , e s p e c i a l l y i n d i s t a l c o n t o u r s i n metacarpophalangeal (MCP) joints [14]. Thus, the definition of the bony edge for JSW measurement is up to the designer of the computer-based method and longitudinal accuracy for the detection of the bony margin may be limited.…”

Novel optical spectral transmission (OST)-guided versus conventionally disease activity-guided treatment: study protocol of a randomized clinical trial on guidance of a treat-to-target strategy for early rheumatoid arthritis

“…Secondary outcomes are the change in HAQ score over time, cost-effectiveness, based on customized cost questionnaires (including direct and indirect costs), and radiographic damage of hand and wrist joints, assessed using a newly developed fully automated radiographic scoring system of joint width of hand and wrist joints [10], as well as the conventional Sharp van der Heijde (SvdH) score of joint width and erosions of hands, wrists, and feet [11].…”

Fully automated joint space width measurement and digital X-ray radiogrammetry in early RA

“…5 In order to minimise the aforementioned limitations, semiautomated and fully automated software to better evaluate joint space width (JSW) have been developed and reviewed. [6][7][8][9][10] The benefits of a fully automated program include higher reproducibility, faster results, observer independence and a higher sensitivity. [11][12][13] Moreover, bone mineral density (BMD) measured with digital X-ray radiogrammetry (DXR) is a recent tool that quantifies BMD in metacarpals 2, 3 and 4.…”