Kallman D A, Wigley F M, Scott W W, Hochberg M C, Tobin J D
Gerontology Research Center, Baltimore, MD 21224.
Arthritis Rheum. 1989 Dec;32(12):1584-91. doi: 10.1002/anr.1780321213.
We developed and evaluated scales for grading the prevalence and progression of the individual radiographic features of osteoarthritis (OA) of the hand. Four equally time-spaced hand radiographs from 50 participants in the Baltimore Longitudinal Study of Aging, who were followed for at least 20 years, were read separately and "blindly" by 4 experienced, trained readers. Eleven hand joints were individually assessed for the presence of osteophytes, joint space narrowing, subchondral cysts, subchondral sclerosis, lateral deformity, and cortical collapse, and were also graded using the Kellgren/Lawrence scale, a global estimate of OA. The intraclass correlation coefficient was used to determine cross-sectional inter- and intrareader reliability. Interreader agreement on OA progression was evaluated using life-table analysis. Each of the grading scales for the individual radiographic features of OA of the hand, except for cysts, were cross-sectionally reliable between readers. Each reader was able to reproduce his original scores almost perfectly when grading the radiographs a second time. Using these scales, the different readers agreed on all the features of longitudinal progression of OA of the hand, except cysts. We believe that this method for grading hand radiographs for OA has proved to be reliable for both cross-sectional and longitudinal studies.
我们开发并评估了用于对手部骨关节炎（OA）个体影像学特征的患病率和进展进行分级的量表。对巴尔的摩纵向衰老研究中50名参与者的四张等时间间隔的手部X光片进行单独且“盲法”阅读，这些参与者至少被随访了20年，由4名经验丰富、经过培训的阅片者进行阅读。对11个手部关节分别评估是否存在骨赘、关节间隙变窄、软骨下囊肿、软骨下硬化、外侧畸形和皮质塌陷，并使用Kellgren/Lawrence量表（一种OA的总体评估方法）进行分级。组内相关系数用于确定阅片者之间和阅片者内部的横断面可靠性。使用寿命表分析评估阅片者之间关于OA进展的一致性。除囊肿外，手部OA个体影像学特征的每个分级量表在阅片者之间的横断面可靠性良好。当第二次对X光片进行分级时，每个阅片者几乎都能完美地重现其原始评分。使用这些量表，除囊肿外，不同阅片者对手部OA纵向进展的所有特征达成了一致。我们认为，这种对手部X光片进行OA分级的方法已被证明在横断面和纵向研究中都是可靠的。
