title: Digital scoring of haemophilic arthropathy using radiographs is feasible.
abstract: Radiographs are important tools to evaluate structural changes in many joint diseases. In the case of haemophilic arthropathy (HA), the Pettersson score is widely used. The rising of digital radiography enables evaluation of these changes in a more quantitative and detailed manner, potentially improving diagnosis and follow-up. The aim of this study was to evaluate whether digital image analysis in the case of HA is feasible, using a presently available method for radiographic changes in knee osteoarthritis (OA), knee image digital analysis (KIDA). Sixty-two knee radiographs were scored according to Pettersson and with KIDA, each by two independent observers. Inter-observer variation and correlations between the two scoring methods were determined. The inter-observer variation was smaller for KIDA than for Pettersson and for KIDA not significantly different from evaluation of OA joints. Good correlations were found for the two methods where comparison of parameters was appropriate. Importantly, for each of the parameters within one point in the ordinal Pettersson score, a large window still existed in the continuous KIDA grading. Digital analysis of radiographs to quantify joint damage in HA is feasible. The use of continuous variables, as used in a digital method such as KIDA has the advantage that it enables objective and much more sensitive detection of small changes than by use of an ordinal analogue method such as the Pettersson score. Based on the present results, it would be worthwhile to adapt the KIDA method for the specific characteristics of HA and to extend the method to elbow and ankle radiographs.
authors.affiliation: Rheumatology & Clinical Immunology, University Medical Center (UMC), Utrecht, The Netherlands. n.w.d.jansen@umcutrecht.nl
authors.forename: N W D
authors.initials: NW
authors.lastname: Jansen
authors.forename: K L
authors.initials: KL
authors.lastname: Vincken
authors.forename: A C A
authors.initials: AC
authors.lastname: Marijnissen
authors.forename: B
authors.initials: B
authors.lastname: Lundin
authors.forename: L
authors.initials: L
authors.lastname: Heijnen
authors.forename: G
authors.initials: G
authors.lastname: Roosendaal
authors.forename: H
authors.initials: H
authors.lastname: Pettersson
authors.forename: F P J G
authors.initials: FP
authors.lastname: Lafeber
mesh_terms: D005240:Feasibility Studies; D006395:Hemarthrosis / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000473:pathology; D006467:Hemophilia A / Q000150:complications*; D002836:Hemophilia B / Q000150:complications*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D007719:Knee Joint / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D015588:Observer Variation; D011859:Radiography; D012720:Severity of Illness Index