ABSTRACT
Background: Osteoarthritis (OA) of knee is one of the major causes in musculoskeletal condition leading to func-tional loss in patients. Determining the progression of the disease is a useful tool which will help in planning of exer-cise programme to slow or halt the disease progression. Measuring the joint space width of the tibio-femoral joint is one of the best options for knowing the disease progression and helps in designing exercise programme. Aim:Retro-spective measurement of joint space width in patients with bilateral tibiofemoral osteoarthritis of knee joint. Method-ology: Data was retrieved from the picture archiving and communication system (PACS) from 1stof February to 22ndof June 2018. Radiographs that were showing OA knee features by using Kellegren Lawrence (KL) grading system were considered and the joint space between the tibial and femoral compartment were measured. Result: The joint space width showed more reduction in the medial compartment of the joint as compared to the lateral compartment. Conclusion: In rural population of Maharashtra the medial joint space is markedly decreased as compared to the lat-eral compartment of the tibiofemoral joint and as the KL grade increases the joint space width decreased.
ABSTRACT
Abstract Objective: To describe the performance of a non-fluoroscopic fixed-flexion PA radiographic protocol with a new positioning device, developed for the assessment of knee osteoarthritis (OA) in Brazilian Longitudinal Study of Adult Health Musculoskeletal Study (ELSA-Brasil MSK). Material and methods: A test–retest design including 19 adults (38 knee images) was conducted. Feasibility of the radiographic protocol was assessed by image quality parameters and presence of radioanatomic alignment according to intermargin distance (IMD) values. Repeatability was assessed for IMD and joint space width (JSW) measured at three different locations. Results: Approximately 90% of knee images presented excellent quality. Frequencies of nearly perfect radioanatomic alignment (IMD ≤1 mm) ranged from 29% to 50%, and satisfactory alignment was found in up to 71% and 76% of the images (IMD ≤1.5 mm and ≤1.7 mm, respectively). Repeatability analyses yielded the following results: IMD [SD of mean difference = 1.08; coefficient of variation (%CV) = 54.68%; intraclass correlation coefficient (ICC) (95%CI) = 0.59 (0.34–0.77)]; JSW [SD of mean difference = 0.34–0.61; %CV = 4.48%–9.80%; ICC (95%CI) = 0.74 (0.55–0.85)–0.94 (0.87–0.97)]. Adequately reproducible measurements of IMD and JSW were found in 68% and 87% of the images, respectively. Conclusions: Despite the difficulty in achieving consistent radioanatomic alignment between subsequent radiographs in terms of IMD, the protocol produced highly repeatable JSW measurements when these were taken at midpoint and 10 mm from the medial extremity of the medial tibial plateau. Therefore, measurements of JSW at these locations can be considered adequate for the assessment of knee OA in ELSA-Brasil MSK.
Resumo Objetivo: Descrever o desempenho de um protocolo radiográfico em flexão fixa sem fluoroscopia em incidência PA com um novo posicionador, desenvolvido para a avaliação da osteoartrite de joelho (OA) no estudo ELSA-Brasil ME. Material e métodos: Fez-se um estudo de teste e reteste que incluiu 19 adultos (38 imagens de joelho). A viabilidade do protocolo radiográfico foi avaliada por meio de parâmetros de qualidade da imagem e presença de alinhamento radioanatômico de acordo com as medidas da distância intermarginal (DIM). Avaliaram-se a repetibilidade dos valores de DIM e do espaço articular (EA) em três locais diferentes. Resultados: Aproximadamente 90% das imagens de joelho apresentaram uma qualidade excelente. As frequências de imagens com alinhamento radioanatômico quase perfeito (DIM<1mm) variaram de 29% a 50%, e de alinhamento satisfatório (DIM<1,5mm e <1,7mm) de 71% a 76%, respectivamente. As análises de repetibilidade produziram os seguintes resultados: DIM [DP da média das diferenças = 1,08; coeficiente de variação (% CV) = 54,68%; coeficiente de correlação intraclasse (CCI) (IC 95%) = 0,59 (0,34 a 0,77)]; EA [DP da média das diferenças = 0,34 a 0,61; % CV = 4,48% a 9,80%; CCI (IC 95%) = 0,74 (0,55 a 0,85) a 0,94 (0,87 a 0,97]. Encontraram-se medidas adequadamente reprodutíveis de DIM e EA em 68% e 87% das imagens, respectivamente. Conclusões: Apesar da dificuldade de obter um alinhamento radioanatômico consistente entre radiografias repetidas em termos de DIM, o protocolo produziu medições de EA altamente repetíveis quando essas foram tomadas no ponto médio e a 10 mm da extremidade medial do platô tibial medial. Portanto, as medidas de EA nesses locais podem ser consideradas adequadas para a avaliação da OA de joelho no estudo ELSA-Brasil ME.
Subject(s)
Humans , Male , Female , Adult , Osteoarthritis, Knee/diagnostic imaging , Patient Positioning/instrumentation , Knee Joint/diagnostic imaging , Image Processing, Computer-Assisted , Brazil , Radiography , Radiography/instrumentation , Feasibility Studies , Reproducibility of Results , Longitudinal Studies , Osteoarthritis, Knee/pathology , Middle AgedABSTRACT
Background: Osteoarthritis is a slowly progressive degenerative disease characterized by gradual loss of articular cartilage. Osteoarthritis is not a normal process of ageing processes. Age related changes are distinct from osteoarthritic changes but when coupled with certain precipitating factors like obesity, muscle weakness and neurological dysfunction may play an important role in the causation of osteoarthritis. Osteoarthritis occurrence appears to increase with patient’s age in a non-linear fashion. The prevalence of disease increases dramatically after the age of 50 years, likely because of age related alterations in collagen and proteoglycan synthesis coupled with diminished nutrient supply to the cartilage. Methods: In this paper presenting the naked eye assessment of radiographic appearance of articular cartilage of knee joints of 100 persons (both men and women) of 35 to 65 years of age with symptoms like pain and stiffness of the joint. Results: Parameters like changes in the joint space width, the presence or absence of osteophytes and subchondral sclerosis and cysts were noted. The correlation between the patient’s age, sex, symptoms and radiological appearance were observed. Conclusion: Osteoarthritis has a higher prevalence and more often generalized in women than in men. Before the age of 50 years, the incidence of osteoarthritis is low and men have a slightly higher prevalence than women, but after the age of 50 years, the disease becomes more frequent and women have a much higher prevalence with a female to male ration of about 12:1. The reason for this is sex difference in cartilage volume.
ABSTRACT
[Objective] Posteroanterior weight-bearing radiographs,made with the knee in 45 degrees of flexion while the patient was standing on the homolateral foot,were compared with the weight-bearing anteroposterior radiographs with both knees in full extention,in order to find a more sensitive method to detect knee osteoarthritis.[Methods]Seventeen osteoarthritis knees were radiographed in the weight-bearing anteroposterior view with both knees in full extention and in the weight-bearing posteroanterior view with the knee in 45 degrees of flexion while standing on the homolateral foot.The minimum joint space width of all the radiograph were measured.The data were analysed statistically with SPSS 11.5.[Results]The mean minimum joint space width of the medial compart in extended knee view and standing on the homolateral foot were 4.65 mm?1.44 mm and 2.52 mm?1.69 mm,respectively(P