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[Comparative study between different radiographic plans in knee osteoarthritis].

Rodrigo Pires e Albuquerque1, Antônio Carlos Pires Carvalho, Vincenzo Giordano

  • 1Serviço de Ortopedia e Traumatologia do Hospital Municipal Miguel Couto-Rio de Janeiro, Brasil. rodalbuquerque@ibest.com.br

Acta Reumatologica Portuguesa
|September 4, 2009
PubMed
Summary

This study compared knee osteoarthritis imaging techniques. While experts agreed on classifications using both AP weight-bearing and Rosenberg views, the Rosenberg view better assessed degeneration, sometimes altering diagnoses.

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Area of Science:

  • Orthopedics
  • Radiology
  • Medical Imaging

Background:

  • Knee osteoarthritis diagnosis relies on radiographic assessment.
  • Standard anteroposterior (AP) weight-bearing views and Rosenberg views are used for classification.
  • Comparative analysis is needed to understand the agreement and diagnostic utility of these views.

Purpose of the Study:

  • To compare the anteroposterior (AP) weight-bearing radiograph of the knee with the Rosenberg view.
  • To assess agreement and disagreement between these radiographic views in classifying knee osteoarthritis using the Ahlbäck criteria.
  • To evaluate the degree of articular degeneration and the advantages of each view.

Main Methods:

  • A prospective study of 111 arthritic knees from 76 patients (average age 62) was conducted.

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  • Radiographs included AP weight-bearing views and Rosenberg views.
  • Kappa statistical analysis was used to assess interobserver agreement between orthopedist and radiologist classifications based on the Ahlbäck score.

    • Main Results:

    • High interobserver agreement was found for both AP weight-bearing (98.2%) and Rosenberg views (88.3%) according to the Ahlbäck score.
    • The AP weight-bearing view showed higher agreement between experts than the Rosenberg view.
    • Agreement between the AP and Rosenberg views was low (27% for orthopedist, 31.5% for radiologist), indicating significant differences in classification between the two methods.

    Conclusions:

    • There is no significant disagreement among experts when classifying knee osteoarthritis using either the AP weight-bearing or Rosenberg view with the Ahlbäck score.
    • The Rosenberg view demonstrated a superior ability to reveal the degree of articular degeneration compared to the AP weight-bearing view.
    • The Rosenberg view's enhanced assessment of degeneration led to changes in osteoarthritis classification in some cases and was routinely adopted.