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.

Understanding haemophilic arthropathy: an exploration of current open issues

“…It will remain even more difficult to address several of the ‘open issues’ in clinical studies. The evaluation of radiographic images by use of the Pettersson score has been reviewed recently and a suggestion for a more detailed evaluation of radiographs using continuous instead of ordinal variables has been demonstrated to be feasible for future clinical evaluation of blood‐induced joint damage (Jansen et al , 2008d). Also, biomarkers of bone and cartilage, as already extensively studied for joint arthropathy due to rheumatoid arthritis and osteoarthritis, may add to more detailed evaluation of blood‐induced joint damage as well.…”

Comparison of the effect of knee synovectomy in haemophilic patients with 153Sm‐ and 90Y ‐labelled hydroxyapatite 1 year after

“…For analysis of effusion frequency behaviour and pain before and after 1 year treatment, the response was rated as: 1 – good (reduction of 65–100% in manifestations); 2 – moderate (reduction of 30–65%); 3 – poor (reduction of <30%). The degree of joint compromise was analysed by Pettersson's radiological scale .…”