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Rev Bras Reumatol Engl Ed. 2017 Mar - Apr;57(2):154-161. doi: 10.1016/j.rbre.2016.11.010. Epub 2016 Dec 22.

Fixed-flexion knee radiography using a new positioning device produced highly repeatable measurements of joint space width: ELSA-Brasil Musculoskeletal Study (ELSA-Brasil MSK).

[Article in English, Portuguese]

Author information

1
Universidade Federal de Minas Gerais, Centro de Investigação ELSA-Brasil de Minas Gerais, Faculdade de Medicina, Belo Horizonte, MG, Brazil. Electronic address: rwtelles@uol.com.br.
2
Universidade Federal de Minas Gerais, Centro de Investigação ELSA-Brasil de Minas Gerais, Faculdade de Medicina, Belo Horizonte, MG, Brazil.

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 ≤1mm) ranged from 29% to 50%, and satisfactory alignment was found in up to 71% and 76% of the images (IMD ≤1.5mm and ≤1.7mm, 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 10mm 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.

KEYWORDS:

Fixed-flexion radiography; Joelho; Joint space width; Knee; Largura do espaço articular; Osteoarthritis; Osteoartrite; Radiografia em flexão fixa; Repeatability; Repetibilidade

PMID:
28343621
DOI:
10.1016/j.rbre.2016.11.010
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