Oka Hiroyuki, Muraki Shigeyuki, Akune Toru, Nakamura Kozo, Kawaguchi Hiroshi, Yoshimura Noriko
Department of Joint Disease Research, 22nd Century Medical and Research Center, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-8655, Japan.
J Orthop Sci. 2010 Nov;15(6):781-9. doi: 10.1007/s00776-010-1545-2. Epub 2010 Nov 30.
Although radiographic severity of the knee is commonly determined by the Kellgren-Lawrence (KL) grading scale, it does not separately assess joint space narrowing or osteophyte formation. The present study aimed to establish normal and threshold values of radiographic parameters for knee osteoarthritis (OA) using the knee osteoarthritis computer-aided diagnosis (KOACAD) measuring system on a large-scale population-based cohort of the Research on Osteoarthritis/Osteoporosis Against Disability (ROAD) population.
From a total of 3040 participants in the ROAD study, standing anteroposterior radiographs of the knee were obtained from 2975 subjects (1041 men, 1934 women) in the ROAD cohort, and 5950 knees were evaluated using the KOACAD system to obtain the medial and lateral minimum joint space width (mJSW), medial and lateral joint space area (JSA), osteophyte area (OPA), and femorotibial angle (FTA). These indices were compared with the KL scores, and cutoff values for radiographic knee OA were determined by receiver operating characteristic (ROC) curve analysis.
The mean KOACAD parameters for KL = 0 were as follows: medial mJSW 3.70 mm; lateral mJSW 4.77 mm, medial JSA 125.0 mm(2), lateral JSA 140.0 mm(2), OPA 0, and FTA 176.1° in men; for women they were medial mJSW 3.26 mm, lateral mJSW 4.22 mm, medial JSA 100.9 mm(2), lateral JSA 111.0 mm(2), OPA 0, and FTA 174.9°. Threshold values for KL ≥ 2 provided by ROC curve analysis with area under the curve (AUC) > 0.7 were medial mJSW 2.8 mm and medial JSA 107.3 mm(2) in men and medial mJSW 2.7 mm in women. Those for KL ≥ 3 were medial mJSW 2.1 mm, medial JSA 81.1 mm(2), OPA 2.4 mm(2), and FTA 179.6° in men; and medial mJSW 2.1 mm, medial JSA 66.6 mm(2), OPA 2.5 mm(2), and FTA 178.1° in women. We then determined the cutoff values for medial knee OA and lateral knee OA.
The present study established normal and threshold values of parameters for knee OA using an automated computer-assisted program on plain radiographs.
尽管膝关节的影像学严重程度通常由凯尔格伦-劳伦斯（KL）分级量表来确定，但该量表并未分别评估关节间隙变窄或骨赘形成情况。本研究旨在利用膝关节骨关节炎计算机辅助诊断（KOACAD）测量系统，在大规模基于人群的骨关节炎/骨质疏松症抗残疾研究（ROAD）队列中，确定膝关节骨关节炎（OA）影像学参数的正常值和阈值。
在ROAD研究的3040名参与者中，从ROAD队列的2975名受试者（1041名男性，1934名女性）获取了膝关节站立前后位X线片，并使用KOACAD系统对5950个膝关节进行评估，以获得内侧和外侧最小关节间隙宽度（mJSW）、内侧和外侧关节间隙面积（JSA）、骨赘面积（OPA）以及股胫角（FTA）。将这些指标与KL评分进行比较，并通过受试者操作特征（ROC）曲线分析确定膝关节OA影像学的截断值。
KL = 0时，男性的KOACAD参数均值如下：内侧mJSW为3.70 mm；外侧mJSW为4.77 mm，内侧JSA为125.0 mm²，外侧JSA为140.0 mm²，OPA为0，FTA为176.1°；女性的相应参数为：内侧mJSW为3.26 mm，外侧mJSW为4.22 mm，内侧JSA为100.9 mm²，外侧JSA为111.0 mm²，OPA为0，FTA为174.9°。ROC曲线分析得出曲线下面积（AUC）> 0.7时，KL≥2的男性阈值为内侧mJSW 2.8 mm和内侧JSA 107.3 mm²，女性为内侧mJSW 2.7 mm。KL≥3时，男性的阈值为内侧mJSW 2.1 mm、内侧JSA 81.1 mm²、OPA 2.4 mm²和FTA 179.6°；女性为内侧mJSW 2.1 mm、内侧JSA 66.6 mm²、OPA 2.5 mm²和FTA 178.1°。然后我们确定了内侧膝关节OA和外侧膝关节OA的截断值。
本研究使用自动计算机辅助程序在普通X线片上确定了膝关节OA参数的正常值和阈值。
