Use of digital x ray radiogrammetry in the assessment of joint damage in rheumatoid arthritis

W. B. Jawaid, D. Crosbie, J. Shotton, David M Reid, Alison Stewart

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Objective: To compare digital x ray radiogrammetry (DXR) with manual radiography for assessing bone loss in RA and examine the relationship of the scores obtained with other disease indices.

Methods: 225 consecutive consenting subjects attending the RA clinic were enrolled. An x ray examination was carried out; demographic details recorded; a self assessment questionnaire completed; blood taken for ESR measurement; and an assessment made by a trained nurse. All x ray films were scored manually using the modified Sharp technique by a single observer; 20 films were rescored by three readers. Films were assessed with the Pronosco X-Posure system, version 2.0. Analysis included chi(2) tests, independent t tests, multiple linear regression, and partial correlations, as appropriate. The smallest detectable difference (SDD), coefficient of variation (CV), and coefficient of repeatability (CR) were determined from Bland and Altman plots.

Results: The DXR precision varied: SDD = 0.002-0.9; CV = 0.09-5.9%; CR = 0.002-0.792, but was better than that of the intra- and interobserver Sharp scores: SDD = 73.9; CV = 27.8%; CR = 33.0-47.6. The DXR measurements, bone mineral density (R-2 = 0.210), metacarpal index (R-2 = 0.222), and cortical thickness (R-2 = 0.215), significantly predicted Sharp scores. In women, DXR measurements significantly correlated with modified HAQ scores but with no other disease indices. Sharp scores significantly correlated with assessor's global assessment, swollen and tender joint counts, pain, HAQ, and DAS28.

Conclusion: DXR measurements are more precise than Sharp scores; both are related to long term disease activity in RA. DXR is simple to use, does not require intensive training, and may identify subjects not responding to standard treatment.

Original languageEnglish
Pages (from-to)459-464
Number of pages5
JournalAnnals of the Rheumatic Diseases
Volume65
Issue number4
DOIs
Publication statusPublished - Apr 2006

Keywords

  • BONE-MINERAL DENSITY
  • RADIOLOGIC ABNORMALITIES
  • DISEASE-ACTIVITY
  • HAND
  • MASS
  • ABSORPTIOMETRY
  • ASSOCIATIONS
  • DENSITOMETRY
  • INFLIXIMAB
  • FRACTURES

Cite this

Use of digital x ray radiogrammetry in the assessment of joint damage in rheumatoid arthritis. / Jawaid, W. B.; Crosbie, D.; Shotton, J.; Reid, David M; Stewart, Alison.

In: Annals of the Rheumatic Diseases, Vol. 65, No. 4, 04.2006, p. 459-464.

Research output: Contribution to journalArticle

Jawaid, W. B. ; Crosbie, D. ; Shotton, J. ; Reid, David M ; Stewart, Alison. / Use of digital x ray radiogrammetry in the assessment of joint damage in rheumatoid arthritis. In: Annals of the Rheumatic Diseases. 2006 ; Vol. 65, No. 4. pp. 459-464.
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abstract = "Objective: To compare digital x ray radiogrammetry (DXR) with manual radiography for assessing bone loss in RA and examine the relationship of the scores obtained with other disease indices.Methods: 225 consecutive consenting subjects attending the RA clinic were enrolled. An x ray examination was carried out; demographic details recorded; a self assessment questionnaire completed; blood taken for ESR measurement; and an assessment made by a trained nurse. All x ray films were scored manually using the modified Sharp technique by a single observer; 20 films were rescored by three readers. Films were assessed with the Pronosco X-Posure system, version 2.0. Analysis included chi(2) tests, independent t tests, multiple linear regression, and partial correlations, as appropriate. The smallest detectable difference (SDD), coefficient of variation (CV), and coefficient of repeatability (CR) were determined from Bland and Altman plots.Results: The DXR precision varied: SDD = 0.002-0.9; CV = 0.09-5.9{\%}; CR = 0.002-0.792, but was better than that of the intra- and interobserver Sharp scores: SDD = 73.9; CV = 27.8{\%}; CR = 33.0-47.6. The DXR measurements, bone mineral density (R-2 = 0.210), metacarpal index (R-2 = 0.222), and cortical thickness (R-2 = 0.215), significantly predicted Sharp scores. In women, DXR measurements significantly correlated with modified HAQ scores but with no other disease indices. Sharp scores significantly correlated with assessor's global assessment, swollen and tender joint counts, pain, HAQ, and DAS28.Conclusion: DXR measurements are more precise than Sharp scores; both are related to long term disease activity in RA. DXR is simple to use, does not require intensive training, and may identify subjects not responding to standard treatment.",
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AU - Crosbie, D.

AU - Shotton, J.

AU - Reid, David M

AU - Stewart, Alison

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N2 - Objective: To compare digital x ray radiogrammetry (DXR) with manual radiography for assessing bone loss in RA and examine the relationship of the scores obtained with other disease indices.Methods: 225 consecutive consenting subjects attending the RA clinic were enrolled. An x ray examination was carried out; demographic details recorded; a self assessment questionnaire completed; blood taken for ESR measurement; and an assessment made by a trained nurse. All x ray films were scored manually using the modified Sharp technique by a single observer; 20 films were rescored by three readers. Films were assessed with the Pronosco X-Posure system, version 2.0. Analysis included chi(2) tests, independent t tests, multiple linear regression, and partial correlations, as appropriate. The smallest detectable difference (SDD), coefficient of variation (CV), and coefficient of repeatability (CR) were determined from Bland and Altman plots.Results: The DXR precision varied: SDD = 0.002-0.9; CV = 0.09-5.9%; CR = 0.002-0.792, but was better than that of the intra- and interobserver Sharp scores: SDD = 73.9; CV = 27.8%; CR = 33.0-47.6. The DXR measurements, bone mineral density (R-2 = 0.210), metacarpal index (R-2 = 0.222), and cortical thickness (R-2 = 0.215), significantly predicted Sharp scores. In women, DXR measurements significantly correlated with modified HAQ scores but with no other disease indices. Sharp scores significantly correlated with assessor's global assessment, swollen and tender joint counts, pain, HAQ, and DAS28.Conclusion: DXR measurements are more precise than Sharp scores; both are related to long term disease activity in RA. DXR is simple to use, does not require intensive training, and may identify subjects not responding to standard treatment.

AB - Objective: To compare digital x ray radiogrammetry (DXR) with manual radiography for assessing bone loss in RA and examine the relationship of the scores obtained with other disease indices.Methods: 225 consecutive consenting subjects attending the RA clinic were enrolled. An x ray examination was carried out; demographic details recorded; a self assessment questionnaire completed; blood taken for ESR measurement; and an assessment made by a trained nurse. All x ray films were scored manually using the modified Sharp technique by a single observer; 20 films were rescored by three readers. Films were assessed with the Pronosco X-Posure system, version 2.0. Analysis included chi(2) tests, independent t tests, multiple linear regression, and partial correlations, as appropriate. The smallest detectable difference (SDD), coefficient of variation (CV), and coefficient of repeatability (CR) were determined from Bland and Altman plots.Results: The DXR precision varied: SDD = 0.002-0.9; CV = 0.09-5.9%; CR = 0.002-0.792, but was better than that of the intra- and interobserver Sharp scores: SDD = 73.9; CV = 27.8%; CR = 33.0-47.6. The DXR measurements, bone mineral density (R-2 = 0.210), metacarpal index (R-2 = 0.222), and cortical thickness (R-2 = 0.215), significantly predicted Sharp scores. In women, DXR measurements significantly correlated with modified HAQ scores but with no other disease indices. Sharp scores significantly correlated with assessor's global assessment, swollen and tender joint counts, pain, HAQ, and DAS28.Conclusion: DXR measurements are more precise than Sharp scores; both are related to long term disease activity in RA. DXR is simple to use, does not require intensive training, and may identify subjects not responding to standard treatment.

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KW - RADIOLOGIC ABNORMALITIES

KW - DISEASE-ACTIVITY

KW - HAND

KW - MASS

KW - ABSORPTIOMETRY

KW - ASSOCIATIONS

KW - DENSITOMETRY

KW - INFLIXIMAB

KW - FRACTURES

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DO - 10.1136/ard.2005.039792

M3 - Article

VL - 65

SP - 459

EP - 464

JO - Annals of the Rheumatic Diseases

JF - Annals of the Rheumatic Diseases

SN - 0003-4967

IS - 4

ER -