Comparison of radiographic joint space width with magnetic resonance imaging cartilage morphometry: Analysis of longitudinal data from the osteoarthritis initiative

Abstract

Objective. Magnetic resonance imaging (MRI) and radiography are established imaging modalities for the assessment of knee osteoarthritis (OA). The objective of our study was to compare the responsiveness of radiographic joint space width (JSW) with MRI-derived measures of cartilage morphometry for OA progression in participants from the Osteoarthritis Initiative (OAI). Methods. This study examined the baseline and 12-month visits of a subset of 150 subjects from the OAI. Measurement of radiographic JSW was facilitated by the use of automated software that delineated the femoral and tibial margins of the joint. Measures of medial compartment minimum JSW and JSW at fixed locations were compared with cartilage morphometry measures derived from MRI. The results were stratified by Kellgren/Lawrence (K/L) scale grade and by tibiofemoral anatomic axis angle. In order to examine the relative responsiveness of various techniques, we calculated the standardized response mean (SRM) between the 2 visits. Results. The SRM for radiographic JSW measured at the optimal location was ؊0.32 compared with ؊0.39 for the most responsive MRI measure. For the subgroup with a K/L scale grade of 2 or 3, the most responsive SRM values were ؊0.34 for radiographic JSW and ؊0.42 for MRI. Conclusion. Our study demonstrates that new measures using a software analysis of digital knee radiographic images are comparable with MRI in detecting OA progression, and potentially superior when considering the cost-effectiveness of the 2 imaging modalities.

An Atlas-Based Approach to Study Morphological Differences in Human Femoral Cartilage Between Subjects from Incidence and Progression Cohorts: MRI Data from Osteoarthritis Initiative

“…A study by Duryea et al proposes measuring the joint space width (JSW) as an improved alternative to the current MR methodology for cartilage morphology. The study demonstrates that the SRM values for radiographic JSW are very much comparable to those obtained from the MRI measures and hence can be a more cost effective alternative (Duryea et al, 2010). Increasingly, studies indicate that sub regional assessment of cartilage volume/thickness is more sensitive than global assessment of longitudinal changes.…”

“…However, they did not find any correlation with the WOMAC score which was attributed to patients getting used to their pain (Phan et al, 2006). Several studies have utilized the longitudinal MR image data available from the Osteoarthritis Initiative (OAI) to study cartilage in OA (Eckstein et al, 2001;Duryea et al, 2010;Thompson, et al, 2010;Guermazi et al, 2011;Iranpour-Boroujeni et al, 2011;Wirth et al, 2011aWirth et al, , 2011b. Eckstein et al performed a study where they investigated the rate at which cartilage deterioration occurs when looking at OAI participants grouped in three categories described as healthy, with no radiographic evidence or risk and knees with radiographic evidence of OA (Kellgren/Lawrence score of 2-4).…”

Accuracy and Reproducibility of Radiographic Knee Joint Space Narrowing Measurements Referenced to the Mid-Coronal Plane

“…Schematic of the central X-ray beam orientation when it is co-planar with the tibial plateau (green arrow) and when it is 15 deg oblique to the tibial plateau (orange arrow). measurement location in the first figure of Duryea et al (6). In the reliability testing reported on the OAI website, the intraclass correlation coefficient (ICC) for the original and repeat measurements of JSW measured at the medial 20% location was 0.987, and the limits of agreement between repeated measurements were -0.339 and 0.319 mm.…”

“…These points are where the lateral and medial JSN is measured. Duryea et al in 2010 reported improved responsiveness of JSN measured at fixed locations [6]. An additional line is drawn that touches the caudal-most points on the medial and lateral femoral condyles.…”

“…radiographic shadow of these margins as a reference for JSN measurements [4][5][6]. When the knee is viewed in the sagittal plane, the anterior and posterior borders of the tibial plateau can be several centimeters anterior or posterior to the actual region where the femoral condyles contact the tibial plateau during standing (Figure 2).…”