Validity of joint space width measurements in hand osteoarthritis

• Published in: Osteoarthritis and cartilage Vol. 19; no. 11; pp. 1349 - 1355
• Main Authors: Kwok, W.Y, Bijsterbosch, J, Malm, S.H, Biermasz, N.R, Huetink, K, Nelissen, R.G, Meulenbelt, I, Huizinga, T.W.J, van ’t Klooster, R, Stoel, B.C, Kloppenburg, M
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.11.2011
• Subjects: Aged; Aged, 80 and over; Case-Control Studies; Female; Finger Joint - diagnostic imaging; Finger Joint - physiopathology; Hand osteoarthritis; Humans; Image Processing, Computer-Assisted; Joint space narrowing; Joint space width; Male; Middle Aged; Osteoarthritis - complications; Osteoarthritis - diagnostic imaging; Osteoarthritis - physiopathology; Osteophyte - etiology; Pain - etiology; Quantification; Radiography; Reproducibility of Results; Rheumatology; Validation; Validation; Joint space width; Joint space narrowing; Quantification; Hand osteoarthritis
• ISSN: 1063-4584; 1522-9653
• DOI: 10.1016/j.joca.2011.08.011

Summary Objective To investigate the validity of joint space width (JSW) measurements in millimeters (mm) in hand osteoarthritis (OA) patients by comparison to controls, grading of joint space narrowing (JSN), and clinical features. Methods Hand radiographs of 235 hand OA patients (mean age 65 years, 83% women) and 471 controls were used. JSW was measured with semi-automated image analysis software in the distal, proximal interphalangeal and metacarpal joints (DIPJs, PIPJs and MCPJs). JSN (grade 0–3) was assessed using the osteoarthritis research society international (OARSI) atlas. Associations between the two methods and clinical determinants (presence of pain, nodes and/or erosions, decreased mobility) were assessed using Generalized Estimating Equations with adjustments for age, sex, body mass index (BMI) and mean width of proximal phalanx. Results JSW was measured in 5631 joints with a mean JSW of 0.98 mm (standard deviation (SD) 0.21), being the smallest for DIPJs (0.70 (SD 0.25)) and largest for MCPJs (1.40 (SD 0.25)). The JSN = 0 group had a mean JSW of 1.28 mm (SD 0.34), the JSN = 3 group 0.17 mm (SD 0.23). Controls had larger JSW than hand OA patients ( P -value < 0.001). In hand OA, females had smaller JSW than men ( β  −0.08, (95% confidence interval (95% CI) −0.15 to −0.01)) and lower JSW was associated with the presence of pain, nodes, erosions and decreased mobility (adjusted β  −0.21 (95% CI −0.27, −0.16), −0.37 (−0.40, −0.34), −0.61 (−0.68, −0.54) and −0.46 (−0.68, −0.24) respectively). These associations were similar for JSN in grades. Conclusion In hand OA the quantitative JSW measurement is a valid method to measure joint space and shows a good relation with clinical features.