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Updated osteoarthritis reference standard

W A Murphy1, R D Altman

  • 1Division of Diagnostic Imaging, University of Texas MD, Anderson Cancer Center, Houston 77030, USA.

The Journal of Rheumatology. Supplement
|February 1, 1995
PubMed
Summary
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A new osteoarthritis (OA) radiographic atlas improves grading accuracy by assessing individual features, addressing limitations of the older Kellgren and Lawrence method for better disease progression assessment.

Area of Science:

  • Radiology
  • Orthopedics
  • Rheumatology

Background:

  • The Kellgren and Lawrence atlas is a long-standing reference for osteoarthritis (OA) radiographic classification.
  • Its limitations include a global grading system, overemphasis on osteophytes, and difficulty in tracking disease progression.
  • Observer variability and bias are significant concerns with the current atlas.

Purpose of the Study:

  • To address the deficiencies of the Kellgren and Lawrence atlas.
  • To optimize observer accuracy, precision, and agreement in radiographic OA assessment.
  • To introduce an updated atlas for more detailed and reliable OA feature scoring.

Main Methods:

  • A consensus-based subset of clinical radiographs was selected by four readers.
  • The updated atlas grades major radiographic features of hand, hip, and knee OA.

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  • Features are scored individually on a 4-point scale.
  • Main Results:

    • The updated atlas allows for individual scoring of relevant OA features per joint.
    • This approach aims to improve upon the limitations of the global grading system.
    • Enhanced precision and agreement among observers are anticipated.

    Conclusions:

    • The updated atlas offers a more detailed method for radiographic OA assessment.
    • It is expected to facilitate more accurate measurement of disease progression.
    • Potential adoption for population studies and clinical trials evaluating new OA treatments is envisioned.