Reliability of radiographic assessment in hip and knee osteoarthritis

Günther, Klaus Peter; Sun, Yi

doi:10.1053/joca.1998.0152

Cited by 94 publications

(70 citation statements)

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“…Using conventional radiography, intrareader reliability for assessment of knee osteoarthritis features has been reported to be lower for less experienced readers in general, even after receiving intensive training, compared to a more experienced reader (23). The same trend was observed in the present study for the tomosynthesis assessment of osteophytes, but not for subchondral cysts.…”

Section: Discussionsupporting

confidence: 80%

Reliability of semiquantitative assessment of osteophytes and subchondral cysts on tomosynthesis images by radiologists with different levels of expertise

Hayashi

Gusenburg³

et al. 2014

Diagn Interv Radiol

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ORIGINAL ARTICLE PURPOSE We aimed to assess reliability of the evaluation of osteophytes and subchondral cysts on tomosynthesis images when read by radiologists with different levels of expertise. MATERIALS AND METHODSForty subjects aged >40 years had both knees evaluated using tomosynthesis. Images were read by an "experienced" reader (musculoskeletal radiologist with prior experience) and an "inexperienced" reader (radiology resident with no prior experience). Readers graded osteophytes from 0 to 3 and noted the presence/absence of subchondral cysts in four locations of the tibiofemoral joint. Twenty knees were randomly selected and re-read. Inter-and intrareader reliabilities were calculated using overall exact percent agreement and weighted κ statistics. Diagnostic performance of the two readers was compared against magnetic resonance imaging readings by an expert reader (professor of musculoskeletal radiology). RESULTSThe experienced reader showed substantial intrareader reliability for graded reading of osteophytes (90%, κ=0.93), osteophyte detection (95%, κ=0.86) and cyst detection (95%, κ=0.83). The inexperienced reader showed perfect intrareader reliability for cyst detection (100%, κ=1.00) but intrareader reliability for graded reading (75%, κ=0.79) and detection (80%, κ=0.61) of osteophytes was lower than the experienced reader. Inter-reader reliability was 61% (κ=0.72) for graded osteophyte reading, 91% (κ=0.82) for osteophyte detection, and 88% (κ=0.66) for cyst detection. Diagnostic performance of the experienced reader was higher than the inexperienced reader regarding osteophyte detection (sensitivity range 0.74-0.95 vs. 0.54-0.75 for all locations) but diagnostic performance was similar for subchondral cysts. CONCLUSION Tomosynthesis offers excellent intrareader reliability regardless of the reader experience, but experience is important for detection of osteophytes.

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Section: Discussionsupporting

confidence: 80%

Reliability of semiquantitative assessment of osteophytes and subchondral cysts on tomosynthesis images by radiologists with different levels of expertise

Hayashi

Gusenburg³

et al. 2014

Diagn Interv Radiol

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“…The intraobserver and interobserver reliability of these systems reportedly ranges from 0.18 to 0.95 [18,19,32,44]. We found that the modified Kellgren-Lawrence, Takakura et al, and van Dijk et al grading systems had reliability ranging from 0.51 to 0.89.…”

Section: Discussionmentioning

confidence: 65%

“…As a result of the focus on osteophytes and the assumption that OA would result in joint space narrowing with the Kellgren-Lawrence grading system, other grading systems have been developed [18,19,32,44,47]. The intraobserver and interobserver reliability of these systems reportedly ranges from 0.18 to 0.95 [18,19,32,44].…”

Section: Discussionmentioning

confidence: 99%

Radiographic Predictability of Cartilage Damage in Medial Ankle Osteoarthritis

Moon¹,

Shim²,

Suh³

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Background Radiographic grading has been used to assess and select between treatment options for ankle osteoarthritis. To use radiographic grading systems in clinical practice and scientific studies one must have reliable systems that predict the fate of the cartilage. Questions/purposes We therefore asked whether (1) radiographic grading of ankle osteoarthritis is reliable and (2) grading reflects cartilage damage observed during arthroscopy. We then (3) determined the sensitivity, specificity, and predictive values of the radiographic findings. Patients and MethodsWe examined 74 ankles with medial osteoarthritis and 24 with normal articular cartilage based on arthroscopy. Arthroscopic findings were graded according to the modified Outerbridge grades and all radiographs were graded using the modified KellgrenLawrence, Takakura et al., and van Dijk et al. grading systems. The reliability of each radiographic grading system was evaluated. We correlated the radiographic grades and severity of cartilage damage for each radiographic grading system. Sensitivity, specificity, and predictive values of spurs and joint space narrowing with or without talar tilting then were determined. Results The interobserver weighted kappa ranged from 0.58 to 0.89 and the intraobserver weighted kappa from 0.51 to 0. The positive predictive value of cartilage damage increased from 77% for medial joint space narrowing regardless of the presence of talar tilting to 98% for medial joint space narrowing with talar tilting. Conclusions Our observations suggest the inclusion of talar tilting in grading schemes enhances the assessment of cartilage damage. Level of Evidence Level II, diagnostic study. See the Guidelines for Authors for a complete description of level of evidence.

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“…This technique has a large intra-user and inter-user variability [3] and relies on a single image to represent the whole joint. The use of a semiautomated computer algorithm can overcome the variability related to manual measurements [4], while the use of MRI can lead to a more precise tracking of the disease.…”

Section: Introductionmentioning

confidence: 99%

Comparison of cartilage thickness with radiologic grade of knee osteoarthritis

Agnesi

Amrami

Frigo³

et al. 2008

Skeletal Radiol

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Objective-To compare joint space width (JSW) measurements obtained from magnetic resonance imaging (MRI) with a semi-automated computer algorithm to the Kellgren and Lawrence grading of osteoarthritis (OA).Materials and methods-Three hundred and six patients (234 female, 72 male) with a mean age of 56.7 years (range 31-81 years) underwent MRI of their knees with a fast oblique spiral spoiled gradient (SPGR) sequence. A board-certified musculoskeletal radiologist graded the OA of all the patients in accordance with the Kellgren and Lawrence OA scale. A previously validated computer algorithm was used to determine the minimum JSW for both the tibiofemoral joint and the patellofemoral joint. An analysis of variance (ANOVA) with the Student-Newman-Kuels post-hoc test was used to determine if there were differences in JSW as a function of OA grade.Results-The radiologic grade of OA was inversely associated with the JSW. In the medial compartment the JSW did not change significantly between grade 1 and grade 2, but there was a significant decrease in JSW between grade 0 (normal) and grade 1 and for each OA grade above grade 2. In the lateral compartment no statistical differences were found till grade 2, while grade 3 was found to be statistically different from the previous one. The number of patients with a grade 4 patellofemoral OA was too low for the statistical significance to be assessed. In the patellofemoral joint the JSW did not change significantly until grade 2, while a statistically significant reduction was found for both grade 3 and grade 4.Conclusion-This study showed that an inverse non-linear relationship exists between radiologic grade and JSW. The relationship differs for the tibiofemoral and the patellofemoral joint.

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Reliability of radiographic assessment in hip and knee osteoarthritis

Abstract: A reliable radiographic severity grading of hip and knee OA is possible with the application of global scores and individual features, if joint specific items are selected and readers are trained enough.

Cited by 94 publications

References 0 publications

Reliability of semiquantitative assessment of osteophytes and subchondral cysts on tomosynthesis images by radiologists with different levels of expertise

Reliability of semiquantitative assessment of osteophytes and subchondral cysts on tomosynthesis images by radiologists with different levels of expertise

Radiographic Predictability of Cartilage Damage in Medial Ankle Osteoarthritis

Comparison of cartilage thickness with radiologic grade of knee osteoarthritis

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