Murphy W A, Altman R D
Division of Diagnostic Imaging, University of Texas MD, Anderson Cancer Center, Houston 77030, USA.
J Rheumatol Suppl. 1995 Feb;43:56-9.
The Kellgren and Lawrence atlas has been the reference standard for radiographic classification of osteoarthritis (OA) for nearly 40 years. Limitations include employment of a global grade, over-emphasis of the osteophyte, and submergence of other features so measurement of disease progression is difficult. Observer bias, drift, and variability cause concern. To address deficiencies and optimize observer accuracy, precision, and agreement, an updated atlas was created. From a photographic set of clinical radiographs, 4 readers selected a subset by consensus. Major radiographic features of hand, hip, and knee OA are graded on a 4-point scale. Using this atlas, it should be possible to individually score each relevant feature in a given joint. It is hoped the atlas will be adopted for population studies, assessment of disease progression, and protocols that evaluate new agents capable of modifying disease.
近40年来，凯尔格伦和劳伦斯图谱一直是骨关节炎（OA）影像学分类的参考标准。其局限性包括采用整体分级、过度强调骨赘以及其他特征被掩盖，因此疾病进展的测量很困难。观察者偏倚、偏差和变异性令人担忧。为了弥补不足并优化观察者的准确性、精确性和一致性，创建了一个更新的图谱。从一组临床X光照片中，4位读者通过协商一致选择了一个子集。手部、髋部和膝部OA的主要影像学特征按4分制分级。使用这个图谱，应该能够对给定关节中的每个相关特征进行单独评分。希望该图谱将被用于人群研究、疾病进展评估以及评估能够改变疾病的新药物的方案。
