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. 1998 Sep;57(9):519–523. doi: 10.1136/ard.57.9.519

Osteoarthritis of the hip: agreement between joint space width measurements on standing and supine conventional radiographs

G Auleley 1, B Rousselin 1, X Ayral 1, R Edouard-Noel 1, M Dougados 1, P Ravaud 1
PMCID: PMC1752744  PMID: 9849309

Abstract

OBJECTIVE—To assess the effect of standing position on joint space width (JSW) measurements of the hips with and without osteoarthritis (OA) on pelvic radiographs.
METHODS—Adult patients aged 18 or more had pelvic anteroposterior conventional radiographs standing and supine performed by a single radiologist in the same radiology unit according to standardised guidelines. JSW measurements in mm were made by a single reader blind to patients' identity and type of view, using a 0.1 mm graduated magnifying glass directly laid over the radiograph, at the narrowest point for OA hips or at the vertical joint space for non-OA hips. Agreement of JSW between both views was assessed using the Bland and Altman graphical analysis.
RESULTS—JSW was greater on standing than supine radiographs, for example, 7.1% for OA hips. Mean (SD) differences and limits of agreement (mm) between both views were 0.08 (0.27) and −0.46 to 0.62 for the 70 non-OA hips, 0.02 (0.31) and −0.60 to 0.64 for the 46 OA hips. Corresponding 95% confidence intervals of mean differences were 0.02, −0.14 mm and −0.07, −0.11 mm.
CONCLUSIONS—Measurements of JSW of the hip on pelvic standing and supine radiographs are concordant. Changes less than or equal to 0.64 mm between the two views are similar or inferior to radiological progression of OA.

 Keywords: hip; osteoarthritis; joint space width; radiograph

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Figure 1  .

Figure 1  

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Differences in joint space width (JSW) (in mm) between standing and supine radiographs against the mean for all hips. Limits of agreement correspond to mean ±2SD.

Figure 2  .

Figure 2  

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(A) Hips without osteoarthritis. Differences in joint space width (JSW) (in mm) between standing and supine radiographs against the mean for hips without osteoarthritis. Limits of agreement correspond to mean ±2SD. (B) Hips with osteoarthritis. Differences in joint space width (JSW) (in mm) between standing and supine radiographs against the mean for hips with osteoarthritis. Limits of agreement correspond to mean ±2SD.

Figure 3  .

Figure 3  

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(A) Standing radiographs. Differences in joint space width (JSW) (in mm) for standing radiographs between two reading sessions against the mean for all hips. Limits of agreement correspond to mean ±2SD. (B) Supine radiographs. Differences in joint space width (JSW) (in mm) for supine radiographs between two reading sessions against the mean for all hips. Limits of agreement correspond to mean ±2SD.

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. Altman R., Alarcón G., Appelrouth D., Bloch D., Borenstein D., Brandt K., Brown C., Cooke T. D., Daniel W., Feldman D. The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hip. Arthritis Rheum. 1991 May;34(5):505–514. doi: 10.1002/art.1780340502. [DOI] [PubMed] [Google Scholar]
  4. Armstrong C. G., Bahrani A. S., Gardner D. L. In vitro measurement of articular cartilage deformations in the intact human hip joint under load. J Bone Joint Surg Am. 1979 Jul;61(5):744–755. [PubMed] [Google Scholar]
  5. Bartko J. J. Measures of agreement: a single procedure. 1994 Mar 15-Apr 15Stat Med. 13(5-7):737–745. doi: 10.1002/sim.4780130534. [DOI] [PubMed] [Google Scholar]
  6. Bland J. M., Altman D. G. Comparing two methods of clinical measurement: a personal history. Int J Epidemiol. 1995;24 (Suppl 1):S7–14. doi: 10.1093/ije/24.supplement_1.s7. [DOI] [PubMed] [Google Scholar]
  7. 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]
  8. Buckland-Wright J. C., Macfarlane D. G., Lynch J. A., Jasani M. K., Bradshaw C. R. Joint space width measures cartilage thickness in osteoarthritis of the knee: high resolution plain film and double contrast macroradiographic investigation. Ann Rheum Dis. 1995 Apr;54(4):263–268. doi: 10.1136/ard.54.4.263. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Bullough P., Goodfellow J., O'Conner J. The relationship between degenerative changes and load-bearing in the human hip. J Bone Joint Surg Br. 1973 Nov;55(4):746–758. [PubMed] [Google Scholar]
  10. Conrozier T., Lequesne M. G., Tron A. M., Mathieu P., Berdah L., Vignon E. The effects of position on the radiographic joint space in osteoarthritis of the hip. Osteoarthritis Cartilage. 1997 Jan;5(1):17–22. doi: 10.1016/s1063-4584(97)80028-3. [DOI] [PubMed] [Google Scholar]
  11. DENHAM R. A. Hip mechanics. J Bone Joint Surg Br. 1959 Aug;41-B:550–557. doi: 10.1302/0301-620X.41B3.550. [DOI] [PubMed] [Google Scholar]
  12. Dieppe P. A. Recommended methodology for assessing the progression of osteoarthritis of the hip and knee joints. Osteoarthritis Cartilage. 1995 Jun;3(2):73–77. doi: 10.1016/s1063-4584(05)80040-8. [DOI] [PubMed] [Google Scholar]
  13. Dieppe P., Cushnaghan J., Jasani M. K., McCrae F., Watt I. A two-year, placebo-controlled trial of non-steroidal anti-inflammatory therapy in osteoarthritis of the knee joint. Br J Rheumatol. 1993 Jul;32(7):595–600. doi: 10.1093/rheumatology/32.7.595. [DOI] [PubMed] [Google Scholar]
  14. Dougados M., Gueguen A., Nguyen M., Berdah L., Lequesne M., Mazieres B., Vignon E. Radiological progression of hip osteoarthritis: definition, risk factors and correlations with clinical status. Ann Rheum Dis. 1996 Jun;55(6):356–362. doi: 10.1136/ard.55.6.356. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Evison G., Reilly P. A., Gray J., Calin A. Comparison of erect and supine radiographs of the hip. Br J Rheumatol. 1987 Oct;26(5):393–394. doi: 10.1093/rheumatology/26.5.393-a. [DOI] [PubMed] [Google Scholar]
  16. Hansson G., Jerre R., Sanders S. M., Wallin J. Radiographic assessment of coxarthrosis following slipped capital femoral epiphysis. A 32-year follow-up study of 151 hips. Acta Radiol. 1993 Mar;34(2):117–123. [PubMed] [Google Scholar]
  17. Hochberg M. C., Altman R. D., Brandt K. D., Moskowitz R. W. Design and conduct of clinical trials in osteoarthritis: preliminary recommendations from a task force of the Osteoarthritis Research Society. J Rheumatol. 1997 Apr;24(4):792–794. [PubMed] [Google Scholar]
  18. Jonsson K., Buckwalter K., Helvie M., Niklason L., Martel W. Precision of hyaline cartilage thickness measurements. Acta Radiol. 1992 May;33(3):234–239. [PubMed] [Google Scholar]
  19. KELLGREN J. H., LAWRENCE J. S. Radiological assessment of osteo-arthrosis. Ann Rheum Dis. 1957 Dec;16(4):494–502. doi: 10.1136/ard.16.4.494. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Leach R. E., Gregg T., Siber F. J. Weight-bearing radiography in osteoarthritis of the knee. Radiology. 1970 Nov;97(2):265–268. doi: 10.1148/97.2.265. [DOI] [PubMed] [Google Scholar]
  21. Ledingham J., Dawson S., Preston B., Milligan G., Doherty M. Radiographic patterns and associations of osteoarthritis of the hip. Ann Rheum Dis. 1992 Oct;51(10):1111–1116. doi: 10.1136/ard.51.10.1111. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Ledingham J., Dawson S., Preston B., Milligan G., Doherty M. Radiographic progression of hospital referred osteoarthritis of the hip. Ann Rheum Dis. 1993 Apr;52(4):263–267. doi: 10.1136/ard.52.4.263. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Lee J., Koh D., Ong C. N. Statistical evaluation of agreement between two methods for measuring a quantitative variable. Comput Biol Med. 1989;19(1):61–70. doi: 10.1016/0010-4825(89)90036-x. [DOI] [PubMed] [Google Scholar]
  24. 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]
  25. Teshima R., Otsuka T., Yamamoto K. Effects of nonweight bearing on the hip. Clin Orthop Relat Res. 1992 Jun;(279):149–156. [PubMed] [Google Scholar]

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