Assessing bone loss on radiographs of the knee in osteoarthritis: A cross-sectional study
Article first published online: 27 OCT 2005
Copyright © 2005 by the American College of Rheumatology
Arthritis & Rheumatism
Volume 52, Issue 11, pages 3536–3541, November 2005
How to Cite
Dieppe, P. A., Reichenbach, S., Williams, S., Gregg, P., Watt, I. and Jüni, P. (2005), Assessing bone loss on radiographs of the knee in osteoarthritis: A cross-sectional study. Arthritis & Rheumatism, 52: 3536–3541. doi: 10.1002/art.21418
- Issue published online: 27 OCT 2005
- Article first published online: 27 OCT 2005
- Manuscript Accepted: 12 AUG 2005
- Manuscript Received: 14 SEP 2004
- British Medical Research Council
- British Arthritis Research Campaign
- Swiss National Science Foundation. Grant Numbers: 3233-066377, 3200-066378
The only established system to grade subchondral bone attrition in knee osteoarthritis (OA) has low interobserver reliability. In this study, our aim was to convert this system into a reliable tool for the assessment of subchondral bone loss in knee OA.
Templates that were designed to outline the normal contours of the knee were overlaid onto conventional radiographs of a random sample of 100 knees of OA patients who were awaiting total knee replacement (TKR). Seventy-five films from individuals with chronic knee pain who were not awaiting TKR and 75 films from asymptomatic control subjects were also assessed. Bone loss was graded from 0 (no attrition) to 3 (severe attrition of >10 mm); other established radiologic features were also graded. Spearman's rho was used to determine the correlation of attrition scores with other features, and logistic regression was used to explore whether definite bone attrition was associated with night pain.
The inter- and intraobserver reliability values were high for attrition scores and for the presence of definite attrition (score ≥2). Bone attrition was evident in 62% of films from patients awaiting TKR, in 9% of films from individuals with chronic knee pain who were not awaiting TKR, and in 1% of films from controls. In all groups, the correlation between attrition and other features was weak to moderate. There was a nonsignificant association between definite bone attrition and night pain.
Bone attrition is an additional dimension of knee OA that can be measured reliably. Definite attrition may be associated with night pain.