Joint space measurement in hand radiographs using computerized image analysis.

OBJECTIVE To compare computerized joint space (JS) measurements with conventional joint space narrowing (JSN) scores in patients with mild rheumatoid arthritis. METHODS Serial paired hand and wrist radiographs from 34 patients with classic rheumatoid arthritis were evaluated. Purpose-written software automatically measured the JS on test images and standard clinical hand radiographs; JSN was scored "blind" by 6 observers. RESULTS The software proved reliable. JS values differed significantly (men > women; metacarpophalangeal > proximal interphalangeal joints), declining with disease duration more than with age; JSN scores correlated poorly and varied more. CONCLUSION Computerization permits sensitive JS measurement and should be of benefit in studies of early joint disease.

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