Ingvarsson T, Hägglund G, Lindberg H, Lohmander L S
Central Hospital, 600 Akureyri, Iceland.
Ann Rheum Dis. 2000 Aug;59(8):650-3. doi: 10.1136/ard.59.8.650.
To compare the reliability of quantitative measurement of minimum hip joint space with a qualitative global assessment of radiological features for estimating the prevalence of primary osteoarthritis (OA) of the hip in colon radiographs.
All colon radiographs from patients aged 35 or older, taken at three different radiographic departments in Iceland during the years 1990-96, were examined. A total of 3002 hips in 638 men and 863 women were analysed. Intraobserver and interobserver reliability was assessed by measuring 147 randomly selected radiographs (294 hips) twice by the same observer, and 87 and 98 randomly selected radiographs (174 and 196 hips) by two additional independent observers. Minimum hip joint space was measured with a millimetre ruler, and global assessment of radiological features by a published atlas.
With a minimum joint space of 2.5 mm or less as definition for OA, 212 hips were defined as having OA. When the global Kellgren and Lawrence assessment with grade 2 (definite narrowing in the presence of definite osteophytes) or higher as definition for OA was used, 202 hips showed OA. However, only 166 hips were diagnosed as OA with both systems. With 2.0 or 3.0 mm minimum joint space as cut off point, the difference between the two methods increased. Both intrarater and interrater reliability was significantly higher with joint space measurement than with global assessment.
Overall prevalence of radiological OA was similar with the two methods. However, the quantitative measurement of minimum hip joint space had a better within-observer and between-observer reliability than qualitative global assessment of radiographic features of hip OA. It is thus suggested that minimum joint space measurement is a preferable method in epidemiological studies of radiological hip OA.
比较在结肠X线片中，通过定量测量最小髋关节间隙与对放射学特征进行定性整体评估来估计髋关节原发性骨关节炎（OA）患病率的可靠性。
对1990 - 1996年间在冰岛三个不同放射科拍摄的35岁及以上患者的所有结肠X线片进行检查。共分析了638名男性和863名女性的3002个髋关节。通过同一名观察者对147张随机选择的X线片（294个髋关节）进行两次测量，以及另外两名独立观察者分别对87张和98张随机选择的X线片（174个和196个髋关节）进行测量，来评估观察者内和观察者间的可靠性。使用毫米尺测量最小髋关节间隙，并依据已发表的图谱对放射学特征进行整体评估。
以最小关节间隙2.5毫米或更小作为OA的定义，212个髋关节被定义为患有OA。当使用Kellgren和Lawrence整体评估，以2级（存在明确骨赘时明确狭窄）或更高等级作为OA的定义时，202个髋关节显示患有OA。然而，两种系统均诊断为OA的仅有166个髋关节。以2.0或3.0毫米最小关节间隙作为截断点时，两种方法之间的差异增大。关节间隙测量的观察者内和观察者间可靠性均显著高于整体评估。
两种方法的放射学OA总体患病率相似。然而，最小髋关节间隙的定量测量在观察者内和观察者间的可靠性优于对髋关节OA放射学特征的定性整体评估。因此，建议在放射学髋关节OA的流行病学研究中，最小关节间隙测量是一种更可取的方法。
