用于膝关节骨关节炎分级的逻辑设计线条图图谱的开发。
Development of a logically devised line drawing atlas for grading of knee osteoarthritis.
作者信息
Nagaosa Y, Mateus M, Hassan B, Lanyon P, Doherty M
机构信息
Academic Rheumatology, University of Nottingham, Clinical Sciences Building, City Hospital, Nottingham NG5 1PB, UK.
出版信息
Ann Rheum Dis. 2000 Aug;59(8):587-95. doi: 10.1136/ard.59.8.587.
OBJECTIVES
To (a) develop an atlas of line drawings for the assessment and grading of narrowing and osteophyte (that is, changes of osteoarthritis) on knee radiographs, and (b) compare the performance of this atlas with that of the standard Osteoarthritis Research Society (OARS) photographic atlas of radiographs.
METHODS
Normal joint space widths (grade 0) for the medial and lateral tibiofemoral and medial and lateral patellofemoral compartments were obtained from a previous community study. Grades 1-3 narrowing in each compartment was calculated separately for men and women, grade 3 being bone on bone, grades 1 and 2 being two thirds and one third the value of grade 0. Maximum osteophyte size (grade 3) for each of eight sites was determined from 715 bilateral knee x ray films obtained in a knee osteoarthritis (OA) hospital clinic; grades 1-2 were calculated as two thirds and one third reductions in the area of grade 3. Drawings for narrowing and osteophyte were presented separately. 50 sets of bilateral knee x ray radiographs (standing, extended anteroposterior; flexed skyline) showing a spectrum of OA grades were scored by three observers, twice using the OARS atlas and twice using the drawn atlas.
RESULTS
Intraobserver and interobserver reproducibility was similar and generally good with both atlases, though varied according to site. All three observers preferred the line drawing atlas for ease and convenience of use. Higher scores for patellofemoral narrowing and lower scores for osteophyte, especially medial femoral osteophyte, were seen using the line drawing atlas, showing that the two atlases are not equivalent instruments.
CONCLUSION
A logically derived line drawing atlas for grading of narrowing and osteophyte at the knee has been produced. The atlas showed comparable reproducibility with the OARS atlas, but was discordant in several aspects of grading. Such a system has several theoretical and practical advantages and should be considered for use in knee OA studies.
目的
(a) 绘制一套线条图图谱，用于评估和分级膝关节X线片上的狭窄和骨赘情况（即骨关节炎的变化）；(b) 将该图谱的性能与标准的骨关节炎研究学会（OARS）X线片摄影图谱进行比较。
方法
从先前的社区研究中获取内侧和外侧胫股关节以及内侧和外侧髌股关节的正常关节间隙宽度（0级）。分别计算男性和女性每个关节间隙1 - 3级的狭窄程度，3级为骨对骨，1级和2级分别为0级值的三分之二和三分之一。从一家膝关节骨关节炎（OA）医院诊所获取的715例双侧膝关节X线片中，确定八个部位每个部位的最大骨赘大小（3级）；1 - 2级计算为3级面积的三分之二和三分之一减少。狭窄和骨赘的线条图分别呈现。由三名观察者对50套双侧膝关节X线片（站立位、伸直前后位；屈曲天际线位）进行评分，这些X线片显示了一系列OA分级，观察者分别使用OARS图谱两次和线条图图谱两次进行评分。
结果
两种图谱的观察者内和观察者间的可重复性相似，总体良好，但因部位而异。所有三名观察者都因使用方便而更喜欢线条图图谱。使用线条图图谱时，髌股关节狭窄得分更高，骨赘得分更低，尤其是股骨内侧骨赘，这表明两种图谱并非等效工具。
结论
已制作出一套用于膝关节狭窄和骨赘分级的逻辑推导线条图图谱。该图谱与OARS图谱具有可比的可重复性，但在分级的几个方面存在不一致。这样的系统具有若干理论和实际优势，应考虑用于膝关节OA研究。
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