Computer-assisted Joint Space Area Measurement: A New Technique in Patients With Knee Osteoarthritis

Abstract

Objectives: This study aims to assess the validity and reproducibility of computer-assisted joint space area measurement in knee roentgenograms of patients with knee osteoarthritis and compare it with a qualitative method in knee roentgenograms and quantitative and semi-quantitative methods in magnetic resonance imaging. Patients and methods:The study included 40 knees of 40 patients diagnosed as osteoarthritis (14 males, 26 females; mean age 57.4±5.9 years; range 47 to 67 years). Only the patients who wrote consents for publication of their radiologic data, and with knee roentgenograms and magnetic resonance images of the same knees were selected. Computer-assisted measurements were applied to joint spaces by two blinded physicians, for two times with an interval of one week. Data were evaluated for intraobserver and interobserver consistency. Also, data were compared with qualitative (Kellgren-Lawrence classification), quantitative (joint space width, cartilage thickness, meniscal thickness in magnetic resonance images) and semi-quantitative methods (whole-organ magnetic resonance imaging score). Results: Intraobserver consistency was evaluated for each physician, which revealed no differences. Interobserver consistency was evaluated by comparing the measurements of two blinded physicians and no differences were found (p>0.05). There was no significant correlation between the grade of Kellgren-Lawrence classification and other variables; such as grade of meniscus, meniscal thickness, cartilage thickness and computerassisted joint space area measurements (p>0.05). While there was a positive correlation between computer-assisted joint space area measurement and other quantitative measurements, there was a negative correlation between computer-assisted joint space area measurement and whole-organ magnetic resonance imaging scores. Conclusion: When compared with qualitative, quantitative, and semi-quantitative methods, computer-assisted joint space area measurement seems to be a useful, reproducible, and cost-effective quantitative method for evaluating knee osteoarthritis.

Fully Automatic Knee Joint Segmentation and Quantitative Analysis for Osteoarthritis from Magnetic Resonance (MR) Images Using a Deep Learning Model

“…From the perspective of potential clinical applications, mJSW measurement (the distance between the distal femur and proximal tibia) has become the standard structural outcome for clinical trials in knee OA. The computer-assisted joint space area measurement (usually assessed in 2D radiographs) is a reproducible and cost-effective quantitative method for evaluating knee OA [ 17 ]. However, the sensitivity of JSW changes in radiography critically depends on medial tibia plateau alignment for 2D X-ray, which poses a considerable challenge in clinical application [ 36 ].…”

“…The mJSW is defined as the distance between the femoral and tibial subchondral bone margins on 2-dimensional (2D) radiographs [ 15 ], which can be performed manually with a lens and a rule, by semi-automated methods, or by fully automated methods [ 16 ]. Compared to measurements with 2D radiographs, 3D MRI-based measurement of the mJSW is assumed to be more accurate without possible errors caused by beam projection [ 15 , 17 ].…”