Mazzuca S
Rheumatology Division, Indiana University School of Medicine, Indianapolis 46202-5103, USA.
Curr Opin Rheumatol. 1997 May;9(3):263-7. doi: 10.1097/00002281-199705000-00015.
The prospects for results of controlled studies of disease-modifying osteoarthritis drugs in humans have fostered interest in radiographic methods to detect early cartilage damage and to assess progressive cartilage changes in osteoarthritis of the knee. We summarize here the extent to which technical factors in plain knee radiography-ie, the degree of knee flexion, misalignment of the x-ray beam, magnification of the radiographic image of the joint-and mensural procedures can impact the reproducibility of quantitative measurements of tibiofemoral joint space width, the surrogate for thickness of articular cartilage. Failure to standardize crucial elements of conventional knee radiography and to computerize measurement of tibiofemoral joint space width will introduce significant (and probably insurmountable) error variation into radiographic outcome data. The level of precision achievable with fluoroscopically-assisted flexion of the knee and rotation of the foot with computerized, magnification-corrected measurement of joint space width greatly improves the feasibility of disease-modifying osteoarthritis drug trials as they relate to sample size and duration of treatment necessary to detect an effect from disease-modifying osteoarthritis drugs.
疾病修饰性骨关节炎药物人体对照研究的结果前景，激发了人们对影像学方法的兴趣，这些方法可用于检测早期软骨损伤，并评估膝关节骨关节炎中软骨的渐进性变化。在此，我们总结了膝关节平片摄影中的技术因素（即膝关节屈曲程度、X射线束未对准、关节X线影像放大）以及测量程序对胫股关节间隙宽度定量测量可重复性的影响程度，胫股关节间隙宽度是关节软骨厚度的替代指标。未能规范传统膝关节摄影的关键要素以及未能实现胫股关节间隙宽度测量的计算机化，将给影像学结果数据引入显著（且可能无法克服）的误差变异。借助荧光透视辅助的膝关节屈曲和足部旋转，并通过计算机化、放大校正的关节间隙宽度测量所达到的精度水平，极大地提高了疾病修饰性骨关节炎药物试验的可行性，因为这涉及到检测疾病修饰性骨关节炎药物效果所需的样本量和治疗持续时间。
