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. 1996 Dec;55(12):875–879. doi: 10.1136/ard.55.12.875

Assessing progression of patellofemoral osteoarthritis: a comparison between two radiographic methods.

P Lanyon 1, A Jones 1, M Doherty 1
PMCID: PMC1010337  PMID: 9014580

Abstract

OBJECTIVE: To compare two plain radiographic methods for sensitivity to detect progression of patellofemoral osteoarthritis. METHODS: Two sets of paired skyline and lateral knee radiographs from 54 hospital referred patients (108 knees) with knee osteoarthritis were taken an average of 31 months apart (range 12-40). Films were examined separately in random order by a single observer blind to patient identity and time order. Minimum joint space was measured by metered caliper; individual features of osteoarthritis were graded 0-3 using an atlas. RESULTS: Intraobserver reproducibility assessed on 40 knees was to within +/- 0.5 mm for skyline lateral facet and +/- 0.7 mm for medial facet and lateral views. On the lateral view measured joint space decreased in 51% of knees but increased in 43%, with overall no significant mean group change with time (-0.2 mm, 95% confidence interval, 0.1 to -0.5). By contrast on the skyline view joint space decreased in at least one facet in 71% of knees, with significant decrease in mean joint space for both lateral facets (-0.4 mm, 95% CI, -0.2 to -0.6) and medial facets (-0.5 mm, 95% CI, -0.1 to -0.8). CONCLUSIONS: It is possible to detect significant joint space loss with time on the skyline view that is not apparent on the lateral view. The skyline view should be the method of choice to detect progression of patellofemoral osteoarthritis.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Altman R. D., Fries J. F., Bloch D. A., Carstens J., Cooke T. D., Genant H., Gofton P., Groth H., McShane D. J., Murphy W. A. Radiographic assessment of progression in osteoarthritis. Arthritis Rheum. 1987 Nov;30(11):1214–1225. doi: 10.1002/art.1780301103. [DOI] [PubMed] [Google Scholar]
  2. Altman R. D., Hochberg M., Murphy W. A., Jr, Wolfe F., Lequesne M. Atlas of individual radiographic features in osteoarthritis. Osteoarthritis Cartilage. 1995 Sep;3 (Suppl A):3–70. [PubMed] [Google Scholar]
  3. Bland J. M., Altman D. G. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986 Feb 8;1(8476):307–310. [PubMed] [Google Scholar]
  4. Buckland-Wright C. Protocols for precise radio-anatomical positioning of the tibiofemoral and patellofemoral compartments of the knee. Osteoarthritis Cartilage. 1995 Sep;3 (Suppl A):71–80. [PubMed] [Google Scholar]
  5. Cicuttini F. M., Baker J., Hart D. J., Spector T. D. Choosing the best method for radiological assessment of patellofemoral osteoarthritis. Ann Rheum Dis. 1996 Feb;55(2):134–136. doi: 10.1136/ard.55.2.134. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Cooper C., Cushnaghan J., Kirwan J. R., Dieppe P. A., Rogers J., McAlindon T., McCrae F. Radiographic assessment of the knee joint in osteoarthritis. Ann Rheum Dis. 1992 Jan;51(1):80–82. doi: 10.1136/ard.51.1.80. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Jones A. C., Ledingham J., McAlindon T., Regan M., Hart D., MacMillan P. J., Doherty M. Radiographic assessment of patellofemoral osteoarthritis. Ann Rheum Dis. 1993 Sep;52(9):655–658. doi: 10.1136/ard.52.9.655. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Laurin C. A., Dussault R., Levesque H. P. The tangential x-ray investigation of the patellofemoral joint: x-ray technique, diagnostic criteria and their interpretation. Clin Orthop Relat Res. 1979 Oct;(144):16–26. [PubMed] [Google Scholar]
  9. Lequesne M., Brandt K., Bellamy N., Moskowitz R., Menkes C. J., Pelletier J. P., Altman R. Guidelines for testing slow acting drugs in osteoarthritis. J Rheumatol Suppl. 1994 Sep;41:65–73. [PubMed] [Google Scholar]
  10. McAlindon T. E., Snow S., Cooper C., Dieppe P. A. Radiographic patterns of osteoarthritis of the knee joint in the community: the importance of the patellofemoral joint. Ann Rheum Dis. 1992 Jul;51(7):844–849. doi: 10.1136/ard.51.7.844. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Merchant A. C., Mercer R. L., Jacobsen R. H., Cool C. R. Roentgenographic analysis of patellofemoral congruence. J Bone Joint Surg Am. 1974 Oct;56(7):1391–1396. [PubMed] [Google Scholar]
  12. Speake S. C., Szebenyi B., Dieppe P. A. Quantitative serial assessment of patellofemoral joint osteoarthritis from lateral knee radiographs. Osteoarthritis Cartilage. 1995 Sep;3 (Suppl A):89–96. [PubMed] [Google Scholar]

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