Buckland-Wright J C, Lynch J A, Macfarlane D G
Division of Anatomy, UMDS, Guys' Hospital, London.
Ann Rheum Dis. 1996 Oct;55(10):749-55. doi: 10.1136/ard.55.10.749.
To determine whether fractal signature analysis (FSA) of digitised macroradiographs of knees quantifies alterations in trabecular structure in the tibial cancellous bone of osteoarthritic patients with either early or definite joint space narrowing compared with non-arthritic subjects.
90 osteoarthritic knees had macroradiographs at x5 magnification. Joint space width and FSA of horizontal and vertical trabecular organisation in the tibial subarticular cancellous bone were measured in the medial and lateral tibio-femoral compartments and compared to reference values obtained from the knees of 14 healthy non-arthritic volunteers, and to the subject's age and weight.
Compared to the non-arthritic joints, FSA of the trabecular structure of the medial diseased compartment of the tibia was significantly different and correlated with the degree of joint space narrowing (P < 0.003); FSA of horizontal trabecular structures decreased (P < 0.001) in knees with early osteoarthritis (joint space > 3 mm) and vertical trabecular FSA increased in knees with marked joint space narrowing (joint space < 3 mm). In the lateral compartment of the tibia, FSA did not show a difference between any of the categories. With increasing age of all subjects, the changes in FSA indicated a significant increase in the number of fine horizontal and vertical trabeculae. No correlation was found between the subjects' body weight and changes in the subarticular cancellous bone organisation.
FSA quantifies changes in cancellous bone organisation in knee osteoarthritis. In the diseased compartment, increased horizontal trabecular thickness occurred early and preceded the later changes in the vertical structures.
确定与非关节炎受试者相比，对膝部数字化放大X线片进行分形特征分析（FSA）能否量化早期或明确关节间隙变窄的骨关节炎患者胫骨松质骨小梁结构的改变。
对90例骨关节炎膝关节进行5倍放大的X线片拍摄。测量胫骨关节面下松质骨水平和垂直小梁结构的关节间隙宽度及FSA，在内侧和外侧胫股关节间进行比较，并与14名健康非关节炎志愿者膝关节的参考值以及受试者的年龄和体重进行比较。
与非关节炎关节相比，胫骨内侧病变关节间小梁结构的FSA有显著差异，且与关节间隙变窄程度相关（P < 0.003）；早期骨关节炎（关节间隙> 3 mm）膝关节的水平小梁结构FSA降低（P < 0.001），而关节间隙明显变窄（关节间隙< 3 mm）的膝关节垂直小梁FSA增加。在胫骨外侧关节间，FSA在任何类别之间均未显示出差异。随着所有受试者年龄的增加，FSA的变化表明水平和垂直细小梁数量显著增加。未发现受试者体重与关节面下松质骨组织变化之间存在相关性。
FSA可量化膝关节骨关节炎松质骨组织的变化。在病变关节间，水平小梁厚度增加较早，先于垂直结构的后期变化。
