Radiographic assessment of progression in osteoarthritis

Roy D Altman, J. F. Fries, D. A. Bloch, J. Carstens, T. D. Cooke, H. Genant, P. Gofton, H. Groth, D. J. McShane, W. A. Murphy, J. T. Sharp, P. Spitz, C. A. Williams, F. Wolfe

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We evaluated methods of grading radiologic progression of osteoarthritis (OA). Sets of radiographs were assessed separately by 8 readers who were blinded to the time sequence. Included radiographs of patients with OA of the hands (24 pairs), hips (40 pairs), and knees (32 pairs). Most films were taken 12-60 months apart. The relative contribution of individual joints (such as particular interphalangeal joints), of observations (such as narrowing or spurs), and of a single joint compartment (such as the medial or lateral compartment of the knee) toward evidence of OA progression was evaluated, as well as the reliability and concordance of scoring, and the sensitivity was achieved by reading a single posteroanterior bilateral hand radiograph for narrowing, spurs, and erosions, and scoring 10 joints (second and third distal interphalangeal, second and third proximal interphalangeal, and trapeziometacarpal joints, bilaterally), using a scale of 0-3. In OA of the hip, a single anteroposterior radiograph assessed for joint space narrowing and cyst formation yielded the greatest sensitivity. In OA of the knee, an anteroposterior radiograph, with weitht-bearing assessed for narrowing, spurs, and sclerosis in both the medial and lateral compartments yielded the greatest sensitivity. These techniques will be useful to the investigator in designing experimental studies and to the clinician in determining the rate of disease progression in an individual patient.

Original languageEnglish (US)
Pages (from-to)1214-1225
Number of pages12
JournalArthritis and Rheumatism
Issue number11
StatePublished - 1987


ASJC Scopus subject areas

  • Immunology
  • Rheumatology

Cite this

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., Sharp, J. T., Spitz, P., Williams, C. A., & Wolfe, F. (1987). Radiographic assessment of progression in osteoarthritis. Arthritis and Rheumatism, 30(11), 1214-1225.