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Severity Mapping Of The Proximal Femur: A New Method For Assessing Hip Osteoarthritis With Computed Tomography.

T. D. Turmezei, D. Lomas, M. Hopper, K. Poole
Published 2014 · Medicine

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OBJECTIVE Plain radiography has been the mainstay of imaging assessment in osteoarthritis for over 50 years, but it does have limitations. Here we present the methodology and results of a new technique for identifying, grading, and mapping the severity and spatial distribution of osteoarthritic disease features at the hip in 3D with clinical computed tomography (CT). DESIGN CT imaging of 456 hips from 230 adult female volunteers (mean age 66 ± 17 years) was reviewed using 3D multiplanar reformatting to identify bone-related radiological features of osteoarthritis, namely osteophytes, subchondral cysts and joint space narrowing. Scoresheets dividing up the femoral head, head-neck region and the joint space were used to register the location and severity of each feature (scored from 0 to 3). Novel 3D cumulative feature severity maps were then created to display where the most severe disease features from each individual were anatomically located across the cohort. RESULTS Feature severity maps showed a propensity for osteophytes at the inferoposterior and superolateral femoral head-neck junction. Subchondral cysts were a less common and less localised phenomenon. Joint space narrowing <1.5 mm was recorded in at least one sector of 83% of hips, but most frequently in the posterolateral joint space. CONCLUSIONS This is the first description of hip osteoarthritis using unenhanced clinical CT in which we describe the co-localisation of posterior osteophytes and joint space narrowing for the first time. We believe this technique can perform several important roles in future osteoarthritis research, including phenotyping and sensitive disease assessment in 3D.
This paper references
In vivo structural analysis of subchondral trabecular bone in osteoarthritis of the hip using multi-detector row CT
千葉 恒 (2011)
10.1136/ard.2002.003780
Influence of radiographic phenotype on risk of hip osteoarthritis within families
P. Lanyon (2004)
Advanced imaging in osteoarthritis.
D. Hunter (2008)
10.1136/ard.2006.066183
The reliability of a new scoring system for knee osteoarthritis MRI and the validity of bone marrow lesion assessment: BLOKS (Boston–Leeds Osteoarthritis Knee Score)
D. Hunter (2008)
10.1136/ARD.2003.018424
The normal hip joint space: variations in width, shape, and architecture on 223 pelvic radiographs.
M. Lequesne (2004)
Herniation pit of the femoral neck.
L. Lee (2000)
10.2214/AJR.128.5.799
Subchondral cysts (geodes) in arthritic disorders: pathologic and radiographic appearance of the hip joint.
D. Resnick (1977)
10.1136/ard.16.4.494
Radiological Assessment of Osteo-Arthrosis
J. H. Kellgren (1957)
10.1007/s00198-012-2169-5
CT imaging for the investigation of subchondral bone in knee osteoarthritis
V. Bousson (2012)
10.1016/J.JOCA.2011.08.001
Corrigendum to Evolution of semi-quantitative whole joint assessment of knee OA: MOAKS (MRI Osteoarthritis Knee Score) [Osteoarthritis and Cartilage 2011;19:990–1002]
David J. Hunter (2011)
10.1007/s00256-009-0792-9
Herniation pits and cystic-appearing lesions at the anterior femoral neck: an anatomical study by MSCT and µCT
S. Panzer (2009)
10.1016/j.joca.2011.04.003
Hip Osteoarthritis MRI Scoring System (HOAMS): reliability and associations with radiographic and clinical findings.
F. Roemer (2011)
Three-dimensional distribution of articular cartilage thickness in the elderly cadaveric acetabulum: a new method using three-dimensional digitizer and CT. Osteoarthritis Cartilage 2010;18(6):795e802
K Akiyama (2010)
10.1148/RADIOL.2422051393
Hyaline cartilage thickness in radiographically normal cadaveric hips: comparison of spiral CT arthrographic and macroscopic measurements.
A. Wyler (2007)
10.1016/J.JOCA.2006.11.009
Atlas of individual radiographic features in osteoarthritis, revised.
R. Altman (2007)
10.1016/j.joca.2012.03.014
Patterns of joint damage seen on MRI in early hip osteoarthritis due to structural hip deformities.
D. Stelzeneder (2012)
10.1148/radiol.10081876
Acetabular cartilage thickness: accuracy of three-dimensional reconstructions from multidetector CT arthrograms in a cadaver study.
Bryce C Allen (2010)
10.1136/ard.41.2.118
Osteoarthritis of the hip: the patient behind the disease.
L. Solomon (1982)
10.1016/J.JOCA.2004.04.004
Measurement of structural progression in osteoarthritis of the hip: the Barcelona consensus group.
R. Altman (2004)
10.1016/j.joca.2010.03.007
Three-dimensional distribution of articular cartilage thickness in the elderly cadaveric acetabulum: a new method using three-dimensional digitizer and CT.
K. Akiyama (2010)
SYMPOSIUM: PAPERS PRESENTED AT THE ANNUAL CLOSED MEETING OF THE INTERNATIONAL HIP SOCIETY The Etiology of Osteoarthritis of the Hip An Integrated Mechanical Concept
R. Ganz (2007)
10.1016/j.joca.2013.04.014
Imaging biomarker validation and qualification report: sixth OARSI Workshop on Imaging in Osteoarthritis combined with third OA Biomarkers Workshop.
D. Hunter (2013)
10.1016/J.JBSPIN.2004.12.014
Contribution of helical computed tomography to the evaluation of early hip osteoarthritis: a study in 18 patients.
C. Alvarez (2005)
10.1007/978-1-4419-7925-4_20
Decision Making with Osteoarthritis
T. Sampson (2013)
10.1007/s00256-004-0828-0
MRI assessment of knee osteoarthritis: Knee Osteoarthritis Scoring System (KOSS)—inter-observer and intra-observer reproducibility of a compartment-based scoring system
P. Kornaat (2004)
10.2214/AJR.157.4.1892040
Osteoarthritis of the knee: comparison of radiography, CT, and MR imaging to assess extent and severity.
W. P. Chan (1991)
10.1016/j.joca.2011.05.004
Evolution of semi-quantitative whole joint assessment of knee OA: MOAKS (MRI Osteoarthritis Knee Score).
D. Hunter (2011)
10.1136/ard.2007.079020
Differences in descriptions of Kellgren and Lawrence grades of knee osteoarthritis
D. Schiphof (2008)
10.1016/j.joca.2010.11.002
In vivo structural analysis of subchondral trabecular bone in osteoarthritis of the hip using multi-detector row CT.
K. Chiba (2011)
10.3389/fendo.2011.00097
Computed Tomography of Subchondral Bone and Osteophytes in Hip Osteoarthritis: the Shape of Things to Come?
T. Turmezei (2011)
10.1093/OXFORDJOURNALS.AJE.A115687
Defining osteoarthritis of the hip for epidemiologic studies.
P. Croft (1990)
Diagnosis of osteoarthritis: imaging. Bone 2012;51(2):278e88
HJ Braun (2012)
Self Compensation of Excessive Anteversion by Osteophytes in Hip Arthritis
H. Mitsui (2013)
10.1016/j.bone.2011.11.019
Diagnosis of osteoarthritis: imaging.
H. Braun (2012)
10.1016/j.joca.2011.08.005
From joint anatomy to clinical outcomes in osteoarthritis and cartilage repair: summary of the fifth annual osteoarthritis imaging workshop.
D. Hunter (2011)
10.1002/acr.20412
Natural history of radiographic hip osteoarthritis: A retrospective cohort study with 11–28 years of followup
J. Franklin (2011)
10.1016/J.JOCA.2003.11.003
Whole-Organ Magnetic Resonance Imaging Score (WORMS) of the knee in osteoarthritis.
C. Peterfy (2004)
10.1088/0031-9155/52/4/024
Contrast agent enhanced pQCT of articular cartilage.
A. Kallioniemi (2007)
Osteophyte developmentemolecular characterization of differentiation stages. Osteoarthritis Cartilage 2003;11(2):141e8
K Gelse (2003)
10.1016/j.joca.2009.01.007
OARSI-OMERACT definition of relevant radiological progression in hip/knee osteoarthritis.
P. Ornetti (2009)
10.1016/j.joca.2014.03.008
A new CT grading system for hip osteoarthritis.
T. D. Turmezei (2014)
10.1302/0301-620X.57B3.314
Osteophytes and the osteoarthritic femoral head.
A. Jeffery (1975)
10.1053/JOCA.2002.0873
Osteophyte development--molecular characterization of differentiation stages.
K. Gelse (2003)
10.1148/radiol.11101359
Advances in imaging of osteoarthritis and cartilage.
F. W. Roemer (2011)
10.1136/ARD.2003.010348
Validity, reliability, and applicability of seven definitions of hip osteoarthritis used in epidemiological studies: a systematic appraisal.
M. Reijman (2004)
Osteoarthritis year 2011 in review: imaging in OAea radiologists’ perspective. Osteoarthritis Cartilage 2012;20(3):207e14
D Hayashi (2012)
10.1016/j.jse.2008.03.012
Pattern of osteophyte distribution in primary osteoarthritis of the elbow.
Yeow Wai Lim (2008)
10.1016/j.joca.2011.12.016
Osteoarthritis year 2011 in review: imaging in OA--a radiologists' perspective.
D. Hayashi (2012)
Radiological assessment of osteoarthrosis
Jh. Kellgren (1957)
10.1002/art.24382
Defining incident radiographic hip osteoarthritis for epidemiologic studies in women.
N. Arden (2009)
10.1148/radiol.12111649
Detection of osteophytes and subchondral cysts in the knee with use of tomosynthesis.
D. Hayashi (2012)
10.1016/j.bone.2010.11.010
Subchondral cysts create increased intra-osseous stress in early knee OA: A finite element analysis using simulated lesions.
D. McErlain (2011)
Atlas of individual radiographic features in osteoarthritis.
R. Altman (1995)
10.1016/j.joca.2011.08.004
Prevalence of symptomatic hip and knee osteoarthritis: a two-phase population-based survey.
F. Guillemin (2011)
Patterns of joint damage seen on MRI in early f the proximal femur: a new method for assessing hip osteoarthritis x.doi.org/10.1016/j.joca.2014.03.007 T.D
D Stelzeneder (2012)
10.1136/ard.51.10.1111
Radiographic patterns and associations of osteoarthritis of the hip.
J. Ledingham (1992)
10.1136/annrheumdis-2012-201575
Progression of osteoarthritis as a state of inertia
D. Felson (2013)
10.1002/HBM.460020402
Statistical parametric maps in functional imaging: A general linear approach
Karl J. Friston (1994)
10.1016/j.joca.2013.05.017
Structural correlates of pain in joints with osteoarthritis.
D. Hunter (2013)



This paper is referenced by
10.1093/rheumatology/kex501
What is the role of imaging in the clinical diagnosis of osteoarthritis and disease management?
X. Wang (2018)
The role of subchondral bone in osteoarthritis
Alan Barr (2016)
10.1590/1806-9061-2015-0217
DIAGNOSTIC APPLICATION OF MULTIROW COMPUTED TOMOGRAPHY OF THE HIP JOINT OF JAPANESE QUAILS (COTURNIX JAPONICA)
Sławomir Paśko (2016)
10.1055/s-0039-1681050
Standard and Advanced Imaging of Hip Osteoarthritis. What the Radiologist Should Know.
B. Huang (2019)
10.1002/jor.24121
Automated femoral version estimation without the distal femur
Nathan J Veilleux (2018)
10.1007/978-3-030-23073-9_4
Prediction of Stress and Strain Patterns from Load Rearrangement in Human Osteoarthritic Femur Head: Finite Element Study with the Integration of Muscular Forces and Friction Contact
F. Bini (2019)
10.1016/j.joca.2014.06.005
The role of imaging modalities in the diagnosis, differential diagnosis and clinical assessment of peripheral joint osteoarthritis.
C. Wenham (2014)
10.17863/CAM.38570
3D Analysis Of The Hip Joint For The Prediction Of Osteoarthritis
I. S. Burkov (2019)
10.1016/j.joca.2014.03.008
A new CT grading system for hip osteoarthritis.
T. D. Turmezei (2014)
10.1007/s00330-015-4048-x
Quantitative 3D analysis of bone in hip osteoarthritis using clinical computed tomography
T. Turmezei (2015)
10.1016/j.berh.2016.09.007
Imaging of osteoarthritis (OA): What is new?
A. Mathiessen (2016)
10.1145/3288200.3288205
3D Detection of Spheric and Aspheric Femoral Heads in Coronal MR Images of Patients with Legg-Calve-Perthes Disease Using the Spherical Hough Transform
Abbas Memis (2018)
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