CLINICAL AND EPIDEMIOLOGICAL RESEARCH

Head-to-head comparison of the Lyon Schuss and fixed flexion radiographic techniques. Long-term reproducibility in normal knees and sensitivity to change in osteoarthritic knees

M-P Hellio Le Graverand¹, E P Vignon², K D Brandt³, S A Mazzuca⁴, M Piperno², R Buck¹, H C Charles⁵, D J Hunter⁶, C G Jackson⁷, V Byers Kraus⁸, T M Link⁹, T J Schnitzer¹⁰, A Vaz¹¹, B Wyman¹

¹ Pfizer GRD, Ann Arbor, Michigan, USA
² Universite Claude Bernard, Lyon, France
³ Kansas University Medical Center, Kansas City, Kansas, USA
⁴ Indiana University School of Medicine, Indianapolis, Indiana, USA
⁵ Duke Image Analysis Laboratory, Durham, North Cordina, USA
⁶ Boston University Clinical Epidemiology Research and Training Unit, Arthritis Center, and Boston Medical Center, Boston, Massachusetts, USA
⁷ University of Utah School of Medicine, Salt Lake City, Utah, USA
⁸ Department of Medicine, Duke University, Durham, North Cordina, USA
⁹ Department of Radiology, University of California, San Francisco, California, USA
¹⁰ Northwestern University, Chicago, Illinois, USA
¹¹ University of Arizona, College of Medicine, Tucson, Arizona, USA

Marie-Pierre Hellio Le Graverand, Pfizer Global Research & Development, 2800 Plymouth Road, Ann Arbor, 48105 MI, USA; helliomp{at}pfizer.com

Objective: The Lyon Schuss (LS) and fixed flexion (FF) views of the knee are superior to a conventional standing anteroposterior view in evaluating joint space narrowing (JSN) in osteoarthritis (OA). Both position the knee identically but only the LS aligns the medial tibial plateau (MTP) with the x-ray beam fluoroscopically. The present study provides the first head-to-head comparison of the LS and FF views.

Methods: At baseline and 12 months, 62 OA and 99 control knees were imaged twice on the same day with LS and FF views. Minimum joint space width (mJSW) was measured by computer and MTP alignment was assessed from the distance between anterior and posterior margins of the MTP (intermargin distance, IMD). Reproducibility of measurements of mJSW and sensitivity to change were evaluated.

Results: In normal knees, JSW did not vary over 12 months with either view. In OA knees, 12-month mJSN was 0.22 (0.43) mm with the LS view and –0.01 (0.46) mm with the FF view (p = 0.0002 and p = 0.92, respectively). Mean IMD was only half as large in LS as in FF views (0.9 (0.5) mm vs 1.9 (1.2) mm, p<0.0001).

Conclusions: LS and FF radiographs offer similar reproducibility in JSW measurement. However, presumably due to its superiority in aligning the MTP, the LS view is much more sensitive to JSN in OA knees.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Le Graverand, M-P H., Brandt, K, Mazzuca, S A, Raunig, D, Vignon, E (2009). Progressive increase in body mass index is not associated with a progressive increase in joint space narrowing in obese women with osteoarthritis of the knee. Ann Rheum Dis 68: 1734-1738 [Abstract] [Full Text]  
• Eckstein, F, Buck, R J, Burstein, D, Charles, H C, Crim, J, Hudelmaier, M, Hunter, D J, Hutchins, G, Jackson, C, Kraus, V B., Lane, N E, Link, T M, Majumdar, L S, Mazzuca, S, Prasad, P V, Schnitzer, T J, Taljanovic, M S, Vaz, A, Wyman, B, Le Graverand, M-P H., on behalf of the A9001140 Study Group, (2008). Precision of 3.0 Tesla quantitative magnetic resonance imaging of cartilage morphology in a multicentre clinical trial. Ann Rheum Dis 67: 1683-1688 [Abstract] [Full Text]