Measurement of joint space width in hip osteoarthritis: influence of joint positioning and radiographic procedure.

OBJECTIVES We assessed the influence of patient positioning and radiographic procedure, and defined a smallest detectable difference (SDD) in hip osteoarthritis (OA). METHODS OA hip patients each had a standardized pelvic radiograph and, 5 min later, a modified pelvic radiograph with the feet internally rotated 5 degrees (part 1 of the study), the X-ray beam centred on the umbilicus (part 2), or another standardized pelvic radiograph (part 3). RESULTS Corresponding mean differences in joint space width (JSW) measurements (limits of agreement) between views were +0.03 (-0.53 to +0.59), -0.31 (-1.15 to +0.53) and -0.02 (-0.48 to +0.44) mm. The two views differed significantly in mean JSW in part 2 of the study (P=1.6x10(-4)), but not in part 1 (P=0.375) and part 3 (P=0.580). The SDD estimate was 0.46 mm. CONCLUSIONS Modifying the X-ray beam and foot rotation increases variability in JSW measurements. Use of urograms to evaluate radiological progression should be avoided. A change greater than 0.46 mm could define radiological hip OA progression.

[1]  P. Gishen,et al.  Radiological assessment of hip osteoarthritis , 1999, The Lancet.

[2]  M. Dougados,et al.  Variability in knee radiographing: implication for definition of radiological progression in medial knee osteoarthritis , 1998, Annals of the rheumatic diseases.

[3]  M. Dougados,et al.  Osteoarthritis of the hip: agreement between joint space width measurements on standing and supine conventional radiographs , 1998, Annals of the rheumatic diseases.

[4]  M. Dougados,et al.  Radiographic assessment in osteoarthritis. , 1997, The Journal of rheumatology.

[5]  Nicholas Bellamy,et al.  Design and conduct of clinical trials in patients with osteoarthritis : Recommendations from a task force of the Osteoarthritic Research Society , 1996 .

[6]  M. Dougados,et al.  Knee joint space width measurement: an experimental study of the influence of radiographic procedure and joint positioning. , 1996, British journal of rheumatology.

[7]  M. Dougados,et al.  Radiological progression of hip osteoarthritis: definition, risk factors and correlations with clinical status. , 1996, Annals of the rheumatic diseases.

[8]  A. Silman,et al.  Hip osteoarthritis and dysplasia in Chinese men. , 1995, Annals of the rheumatic diseases.

[9]  P A Dieppe,et al.  Recommended methodology for assessing the progression of osteoarthritis of the hip and knee joints. , 1995, Osteoarthritis and cartilage.

[10]  J. Lynch,et al.  Joint space width measures cartilage thickness in osteoarthritis of the knee: high resolution plain film and double contrast macroradiographic investigation. , 1995, Annals of the rheumatic diseases.

[11]  D. Coggon,et al.  Osteoarthritis of the hip joint and acetabular dysplasia in women. , 1995, Annals of the rheumatic diseases.

[12]  J. Buckland-Wright,et al.  Quantitative radiography of osteoarthritis. , 1994, Annals of the rheumatic diseases.

[13]  J. Lynch,et al.  Precision of joint space width measurement in knee osteoarthritis from digital image analysis of high definition macroradiographs. , 1993, Osteoarthritis and cartilage.

[14]  R. Jerre,et al.  Radiographic Assessment of Coxarthrosis following Slipped Capital Femoral Epiphysis , 1993, Acta radiologica.

[15]  T. Spector,et al.  Radiological progression of osteoarthritis: an 11 year follow up study of the knee. , 1992, Annals of the rheumatic diseases.

[16]  M. Helvie,et al.  Precision of Hyaline Cartilage Thickness Measurements , 1992, Acta radiologica.

[17]  M Lequesne,et al.  Longitudinal radiologic evaluation of osteoarthritis of the knee. , 1992, The Journal of rheumatology.

[18]  D Coggon,et al.  Osteoarthritis of the hip and acetabular dysplasia. , 1991, Annals of the rheumatic diseases.

[19]  C. Cooper,et al.  Defining osteoarthritis of the hip for epidemiologic studies. , 1990, American journal of epidemiology.

[20]  D. Resnick.  Diagnosis of Bone and Joint Disorders , 1987 .

[21]  T D Cooke,et al.  Radiographic assessment of progression in osteoarthritis. , 1987, Arthritis and rheumatism.

[22]  D. Altman,et al.  STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT , 1986, The Lancet.

[23]  R. Leach,et al.  Weight-bearing radiography in osteoarthritis of the knee. , 1970, Radiology.

[24]  J. Kellgren,et al.  Radiological Assessment of Osteo-Arthrosis , 1957, Annals of the rheumatic diseases.

[25]  E. Vignon,et al.  The effects of position on the radiographic joint space in osteoarthritis of the hip. , 1997, Osteoarthritis and cartilage.

[26]  D G Altman,et al.  Comparing two methods of clinical measurement: a personal history. , 1995, International journal of epidemiology.

[27]  R. Altman.  The classification of osteoarthritis. , 1995, The Journal of rheumatology. Supplement.