Comparison of features by MRI and radiographs of the interphalangeal finger joints in patients with hand osteoarthritis

ObjectivesTo examine the construct validity of MRI in the detection of structural hand osteoarthritis features with conventional radiography (CR) as reference and explore the association between radiographic severity and MRI-defined pathology.Methods106 hand osteoarthritis patients (97 women, mean age 68.9 years (SD 5.6)) had 1.0T contrast-enhanced MRI and CR of the dominant hand. The 2nd–5th interphalangeal joints were scored according to the preliminary Oslo hand osteoarthritis MRI score and Kellgren–Lawrence (KL) scale and Osteoarthritis Research Society International atlas for radiographs. The authors compared the number of joints with structural features by MRI and CR (Wilcoxon signed-rank test) and examined concordance at the individual joint level. The OR of MRI features in joints with doubtful (KL grade 1), mild (2) and moderate/severe (≥3) radiographic osteoarthritis was estimated by generalised estimating equations (KL grade 0 as reference).ResultsMRI detected approximately twice as many joints with erosions and osteophytes compared with CR (p<0.001), but identification of joint space narrowing, cysts and malalignment was similar. The sensitivity of MRI was very high for osteophytes (1.00) and erosions (0.95), while specificity was lower (0.22 and 0.63). The prevalence of most MRI features increased with radiographic severity, but synovitis was more frequent in joints with mild osteoarthritis (OR2.1, 95% CI 1.4 to 3.2) than in moderate/severe osteoarthritis (OR1.4, 95% CI 1.0 to 2.2).ConclusionMRI detected more osteophytes and erosions than CR, suggesting that erosive osteoarthritis may be more common than indicated by CR. Synovitis was most common in mild osteoarthritis. Whether this is due to burn-out of inflammation in late disease must be investigated further.

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Magnetic Resonance Imaging in Hand Osteoarthritis: Intraobserver Reliability and Criterion Validity for Clinical and Structural Characteristics

The Journal of Rheumatology ◽

10.3899/jrheum.140338 ◽

2015 ◽

Vol 42 (7) ◽

pp. 1224-1230 ◽

Cited By ~ 16

Author(s):

Marion C. Kortekaas ◽

Wing-Yee Kwok ◽

Monique Reijnierse ◽

Ron Wolterbeek ◽

Pernille Bøyesen ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Structural Characteristics ◽

Structural Features ◽

Criterion Validity ◽

Intraobserver Reliability ◽

Hand Osteoarthritis ◽

Resonance Imaging ◽

Scoring Method ◽

Mri Features

Objective.To investigate criterion validity and intraobserver reliability of magnetic resonance imaging (MRI) in hand osteoarthritis (HOA).Methods.In 16 patients with HOA (median age 57 yrs, 62% women, 13 with erosive OA), 3 Tesla MRI scans with gadolinium-chelate administration of right second to fifth distal interphalangeal/proximal interphalangeal joints were scored according to the Oslo HOA scoring method for synovial thickening, bone marrow lesions (BML), osteophytes, joint space narrowing (JSN), and erosions (grade 0–3). Ultrasound (US) was scored for synovial thickening and osteophytes, radiographs for osteophytes and JSN (Osteoarthritis Research Society International score), and anatomical phases (Verbruggen-Veys score). Pain was assessed during physical examination. Correlations of MRI with US and radiographic features were assessed with generalizability theory. With generalized estimating equations analyses, MRI features were associated with pain, adjusting for confounding.Results.Forty-three percent, 27%, 77%, and 61% of joints had synovial thickening (moderate/severe), BML, osteophytes, and erosions on MRI, respectively. Intraobserver reliability, assessed in 6 patients, was good (ICC 0.77–1.00). Correlations between osteophytes, JSN, and erosions on radiographs and MRI were moderate, substantial, and fair (ICC 0.53, 0.68, and 0.32, respectively); MRI showed more lesions than radiography. Correlation between synovial thickening and osteophytes on MRI and US was moderate (ICC 0.43 and 0.49, respectively). MRI was more sensitive for synovial thickening, US for osteophytes. Pain was associated with moderate/severe synovial thickening (adjusted OR 2.4, 95% CI 1.06–5.5), collateral ligaments (4.2, 2.2–8.3), BML (3.5, 1.6–7.7), erosions (4.5, 1.7–12.2), and osteophytes (2.4, 1.1–5.2).Conclusion.MRI is a reliable and valid method to assess inflammatory and structural features in HOA. It gives additional information over radiographs and US.

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Presence of Autoantibodies in Erosive Hand Osteoarthritis and Association with Clinical Presentation

The Journal of Rheumatology ◽

10.3899/jrheum.180256 ◽

2018 ◽

Vol 46 (1) ◽

pp. 101-105 ◽

Cited By ~ 3

Author(s):

Myrthe Alexandra Maria van Delft ◽

Sjoerd van Beest ◽

Margreet Kloppenburg ◽

Leendert Adrianus Trouw ◽

Andreea Ioan-Facsinay

Keyword(s):

Structural Damage ◽

Joint Space ◽

Research Society ◽

Nonparametric Tests ◽

Hand Osteoarthritis ◽

Erosive Disease ◽

Reactive Protein ◽

Erosive Hand Osteoarthritis ◽

Osteoarthritis Research Society ◽

Hand Radiographs

Objective.To investigate whether 3 rheumatoid arthritis–associated antibodies [rheumatoid factor (RF) and anticitrullinated protein antibodies (ACPA) or anticarbamylated protein (anti-CarP) antibodies] are present in hand osteoarthritis (HOA) and associate with erosive OA (EOA).Methods.Anti-CarP IgG was measured by ELISA in baseline sera of patients with HOA from 3 cohorts: HOSTAS (n = 510, 27.2% EOA), ECHO (n = 47), and EHOA (n = 23), and in sera of healthy controls (HC; n = 196, mean age 44.1 yrs, 51.0% women). Moreover, ACPA-IgG and RF-IgM were additionally determined in HOSTAS and HC. The prevalence of autoantibodies was compared between HOA and HC and between erosive and nonerosive HOA. In HOSTAS, hand radiographs were scored (Kellgren-Lawrence, Osteoarthritis Research Society International osteophyte and joint space narrowing) and C-reactive protein (CRP) levels, representing inflammation, were assessed. Groups were compared using nonparametric tests.Results.The prevalence of anti-CarP was low and not significantly different between the total HOA group and HC (6.6% vs 3.6%, p = 0.12). In HOSTAS, the prevalence of all tested autoantibodies was low (anti-CarP 7.1%, ACPA 0.8%, RF 6.1%), and there were no significant differences observed between HOA patients and HC or between erosive and nonerosive HOA. Further, radiographic damage and CRP levels were similar in anti-CarP+ and anti-CarP–, and RF+ and RF− HOSTAS patients.Conclusion.The prevalence of autoantibodies is similar in HOA patients and HC, and these autoantibodies are not associated with erosive disease, structural damage, or inflammation in patients with HOA, indicating that another mechanism is driving erosive disease.

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Bone marrow lesions and synovitis on MRI associate with radiographic progression after 2 years in hand osteoarthritis

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2015-209036 ◽

2016 ◽

Vol 76 (1) ◽

pp. 214-217 ◽

Cited By ~ 27

Author(s):

W Damman ◽

R Liu ◽

JL Bloem ◽

FR Rosendaal ◽

M Reijnierse ◽

...

Keyword(s):

Bone Marrow ◽

Radiographic Progression ◽

Joint Space ◽

Research Society ◽

Proximal Interphalangeal Joint ◽

Hand Osteoarthritis ◽

Bone Marrow Lesions ◽

Adjusted Risk ◽

Patient Level ◽

End Stage

ObjectiveTo study the association of magnetic resonance (MR) features with radiographic progression of hand osteoarthritis over 2 years.MethodsOf 87 primary patients with hand osteoarthritis (82% women, mean age 59 years), baseline distal and proximal interphalangeal joint contrast-enhanced MR images were scored 0–3 for bone marrow lesions (BMLs) and synovitis following the Oslo score. Baseline and 2-year follow-up radiographs were scored following Kellgren-Lawrence (KL) (0–4) and OsteoArthritis Research Society International (OARSI) scoring methods (0–3 osteophytes, joint space narrowing (JSN)). Increase ≥1 defined progression. Associations between MR features and radiographic progression were explored on joint and on patient level, adjusting for age, sex, body mass index, synovitis and BML. Joints in end-stage were excluded.ResultsOf 696 analysed joints, 324 had baseline KL=0, 28 KL=4 and after 2 years 78 joints progressed. BML grade 2/3 was associated with KL progression (2/3 vs 0: adjusted risk ratio (RR) (95% CI) 3.3 (2.1 to 5.3)) and with osteophyte or JSN progression, as was synovitis. Summated scores were associated with radiographic progression on patient level (RR crude BML 1.08 (1.01 to 1.2), synovitis 1.09 (1.04 to 1.1), adjusted synovitis 1.08 (1.03 to 1.1)).ConclusionsBMLs, next to synovitis, show, already after 2 years, graded associations with radiographic progression, suggesting that both joint tissues could be important targets for therapy.

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AB1112 THE DIAGNOSTIC OF THE OSTEOARTHRITIS OF THE HANDS BY CONVENTIONAL RADIOGRAPHY

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.5326 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1845.2-1846

Author(s):

D. Kudinsky ◽

L. Alekseeva ◽

A. Smirnov ◽

A. Volkov ◽

O. Alekseeva ◽

...

Keyword(s):

Disease Duration ◽

Conventional Radiography ◽

Joint Space ◽

Diagnostic Methods ◽

Stage Ii ◽

L System ◽

Informed Consent Form ◽

Independent Form ◽

Duration Of Disease ◽

Radiological Changes

Background:The most severe phenotype of osteoarthritis (OA) is currently considered to be an inflammatory or erosive phenotype (EOA). There is currently no reliable x-ray picture of this disease in the literature, and the question of whether it is an independent form of OA, a natural more pronounced stage of progression, or a separate nosology is debated in the literature.Objectives:To identify the localization, frequency, and severity of pain and radiological symptoms in patients with EOA and non-erosive (NOA) disease in the interphalangeal (DIP and PIP) and metacarpal (MCP) joints of the hands.Methods:64 women with diagnosis of OA of the hand (HOA) joints according to the ACR criteria were included into study after signing the informed consent form. Mean age was 65.28 ± 6.82 years (48-77), mean BMI 27,7 ± 4,4 kg/m2, mean disease duration 12 ± 8,1 years. Individual patient’s medical record included relevant anthropometric data, records from case history and clinical examination, AUSCAN scores, patient’s articular status. Instrumental diagnostic methods included plain radiography of the hand joints in an anterior-posterior projection. The images were described in accordance with the Kellgren&Lawrence (K&L) system.When evaluating radiographs of 64 patients with HOA, the most common was stage II (49%) according to K&L, and the most common symptoms in distal (DIP), proximal (PIP) interphalangeal and MCP were joint space narrowing (JSN) (100%, 100%, and 95%, respectively) and osteophytes (OP) (88%, 70%, and 45%, respectively). Subchondral osteosclerosis (SO) (5%), erosions (8%), and subluxations (3%) in MCP, as well as subluxation in PIP (6%) were less common. Statistica 10.0 was used for statistical analysis.23 patients had EOA, 37 had NOA. Depending on the presence of erosions in interphalangeal joints patients were divided into 2 groups comparable in terms of age, age of OA onset and duration of disease (the average age of patients with EOA interphalangeal joints was 68 + 6.15 years, and mean disease duration 18,34 + 7.11 years; in the group without erosive changes in the average age amounted to 65,13±5.43 years, mean disease duration of 16.56±8.4 years).Results:EOA DIP and PIP was detected in 15 (23%) with radiological changes corresponding to stages III-IV of HOA and in 8 people (12%) with stage II on the K&L scale. Patients with stage I according to standard radiography had no erosive process.In DMFs OP (100% and 78%, OR=1.28, 95%, CI [1.08-1.5], p=0.02), SO (74% and 11%, OR=6.8, 95%, CI [2.6-17.8], p<0,0001), subchondral cysts (SC) (61% and 24%, OR=2.5, 95%, CI [1.3-4.82], p=0.005) and subluxations (43% and 14%, OR=3.2, 95%, CI [1.3-8.23], p=0.01) were significantly more often found in patients with EOA. In PIPs SO (43% AND 5%, OR=8.04, 95%, CI [1.93-33.5], p=0.0005), SC (52% and 27%, OR=1.93, 95%, CI [0.1-3.73], p=0.045) and subluxations (17% and 0%, p=0.01) were significantly more frequently detected in patients with EOA compared to the non-erosive group. According to the results of the AUSCAN questionnaire, a significantly greater severity of pain was found in patients with EOA (65%) in comparison with the non-erosive (30%) form of HOA (OR=2.19, 95%, CI [1.23-3.9], p=0.008).Conclusion:DIPs is most often affected in OA of interphalangeal joints, less often PIPs, the most common symptoms are JSN and OP. At EOA in addition to more frequent detection OP, cysts, SO, subluxations in DIPs, SO, cysts and subluxations in PIPs, there is also significantly more pronounced pain according to AUSCAN data, it can be concluded that EOA is more severe in comparison with the non-erosive form of HOA.Disclosure of Interests:Danil Kudinsky: None declared, Ludmila Alekseeva Grant/research support from: Bayer, Alexander Smirnov: None declared, Alexander Volkov: None declared, Olga Alekseeva: None declared, Elena Taskina: None declared, Anastasiia Sukhinina: None declared

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AB0867 INCREASED ADIPONECTIN LEVELS ARE ASSOCIATED WITH HIGHER RADIOGRAPHIC SCORES IN THE KNEE JOINT, BUT NOT IN THE HAND JOINT: THE DONG-GU STUDY

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.1677 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1740.1-1740

Author(s):

J. H. Kang ◽

S. E. Choi ◽

H. Xu ◽

D. J. Park ◽

S. S. Lee

Keyword(s):

Body Mass Index ◽

Knee Joint ◽

Body Mass ◽

Linear Regression Analysis ◽

Joint Space ◽

Serum Adiponectin ◽

Hand Osteoarthritis ◽

X Rays ◽

Subchondral Cyst ◽

The Relationship

Background:Several studies have evaluated the association between serum adiponectin levels and knee and hand osteoarthritis (OA), with mixed results.Objectives:The aim of this study was to investigate the relationship between OA and serum adiponectin levels according to the radiographic features of knee and hand OA.Methods:A total of 2,402 subjects were recruited from the Dong-gu Study. Baseline characteristics were collected via a questionnaire, and X-rays of knee and hand joints were scored by a semi-quantitative grading system. The relationship between serum adiponectin levels and radiographic severity was evaluated by linear regression analysis.Results:Subjects with higher tertiles of serum adiponectin were older and had a lower body mass index than those with lower tertiles. In the knee joint scores, serum adiponectin levels were positively associated with the total score (P<0.001), osteophyte score (P=0.003), and joint space narrowing (JSN) score (P<0.001) among the three tertiles after adjustment for age, sex, body mass index, smoking, alcohol consumption, education, and physical activity. In the hand joint scores, no association was found between serum adiponectin levels and the total score, osteophyte score, JSN score, subchondral cyst score, sclerosis score, erosion score, and malalignment score among the three tertiles after adjustment.Conclusion:In this study, we found that increased adiponectin levels were associated with higher radiographic scores in the knee joint, but not in the hand joint, suggesting different pathophysiologic mechanisms in the development of OA.Disclosure of Interests:None declared

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An Automated Histologic System for 3D Histomorphometry of the Mouse Knee

ASME 2011 Summer Bioengineering Conference, Parts A and B ◽

10.1115/sbc2011-53443 ◽

2011 ◽

Author(s):

Barbara J. Murienne ◽

Michael J. Girard ◽

Lise Loerup ◽

Alexandra Boussommier-Calleja ◽

Sandra J. Shefelbine ◽

...

Keyword(s):

Joint Space ◽

Bone Defects ◽

Structural Features ◽

Degenerative Joint Disease ◽

Cartilage Volume ◽

Joint Disease ◽

Point Counting ◽

Geometrical Properties ◽

3 Dimensional ◽

And Cartilage

Osteoarthritis (OA) is a degenerative joint disease that is a leading cause of adult pain and disability in Western countries1. Clinically, several structural features of the joint are important in diagnosis, prognosis and evaluation of treatment efficacy, e.g. cartilage volume, homogeneity and joint space narrowing2,3. In animal models of OA, structural features such as bone defects and cartilage changes are commonly investigated using histomorphometry, a technique that uses stereological point counting and manual tracing of regions of interest to extract 3-dimensional (3D) geometrical properties from 2D histology slides. This is time-consuming and subject to inter-observer variations, hence limiting precision 4,5. Therefore, a technique for rapidly imaging joint structures in 3D at high resolution, including articular cartilage and subchondral bone, is currently needed in pre-clinical OA research.

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Diclofenac Sodium Gel in Patients with Primary Hand Osteoarthritis: A Randomized, Double-blind, Placebo-controlled Trial

The Journal of Rheumatology ◽

10.3899/jrheum.081316 ◽

2009 ◽

Vol 36 (9) ◽

pp. 1991-1999 ◽

Cited By ~ 78

Author(s):

ROY D. ALTMAN ◽

RENÉE-LILIANE DREISER ◽

CHESTER L. FISHER ◽

WALTER F. CHASE ◽

DONATUS S. DREHER ◽

...

Keyword(s):

Disease Activity ◽

Pain Intensity ◽

Primary Outcome ◽

Controlled Trial ◽

Diclofenac Sodium ◽

Global Rating ◽

Hand Osteoarthritis ◽

Dominant Hand ◽

Double Blind ◽

Secondary Outcomes

Objective.To measure the efficacy and safety of diclofenac sodium gel in patients with primary hand osteoarthritis (OA).Methods.In a randomized, double-blind, placebo-controlled trial, men and women aged ≥ 40 years diagnosed with primary OA in the dominant hand were randomly assigned to self-apply topical 1% diclofenac sodium gel (Voltaren® Gel) (n = 198) or vehicle (n = 187) to both hands 4 times daily for 8 weeks. Primary outcome measures included OA pain intensity (100-mm visual analog scale), total Australian/Canadian Osteoarthritis Hand Index (AUSCAN) score, and global rating of disease activity at 4 and 6 weeks. Secondary outcomes included onset of efficacy in Weeks 1 and 2, durability of efficacy at 8 weeks, measures of disease activity in the dominant hand, pain intensity in the non-dominant hand, AUSCAN subindices, end of study rating of efficacy, and Osteoarthritis Research Society International response criteria.Results.Diclofenac sodium gel decreased pain intensity scores by 42%–45%, total AUSCAN scores by 35%–40%, and global rating of disease by 36%–40%. Significant differences favoring diclofenac sodium gel over vehicle were observed at Week 4 for pain intensity and AUSCAN, with a trend for global rating of disease activity. At Week 6, diclofenac sodium gel treatment significantly improved each primary outcome measure compared with vehicle. Secondary outcomes generally supported the primary outcomes. The most common treatment-related adverse event (AE) was application-site paresthesia. Most AE were mild. No cardiac events, gastrointestinal bleeding, or ulcers were reported.Conclusion.Topical diclofenac sodium gel was generally well tolerated and effective in primary hand OA. (NCT ID: NCT00171665)

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Radiographic joint space width in a case-control hand osteoarthritis study: Are healthy joints really healthy?

Osteoarthritis and Cartilage ◽

10.1016/j.joca.2019.02.068 ◽

2019 ◽

Vol 27 ◽

pp. S47-S48

Author(s):

I. Onuoha ◽

R. Lu ◽

A. Mathiessen ◽

J.B. Driban ◽

M.B. Roberts ◽

...

Keyword(s):

Joint Space Width ◽

Joint Space ◽

Case Control ◽

Hand Osteoarthritis ◽

Space Width

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Increased radiographic progression of distal hand osteoarthritis occurring during biologic DMARD monotherapy for concomitant rheumatoid arthritis

Arthritis Research & Therapy ◽

10.1186/s13075-021-02654-0 ◽

2021 ◽

Vol 23 (1) ◽

Author(s):

C. A. Lechtenboehmer ◽

T. Burkard ◽

S. Reichenbach ◽

U. A. Walker ◽

A. M. Burden ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Joint Space Narrowing ◽

Radiographic Progression ◽

Cox Regression ◽

Joint Space ◽

Estimating Equation ◽

Considerable Proportion ◽

Hand Osteoarthritis ◽

Increased Risk ◽

Subchondral Sclerosis

Abstract Objectives A considerable proportion of patients with rheumatoid arthritis (RA) also suffer from hand osteoarthritis (OA). We here assess the association between conventional synthetic (cs) and biological (b) disease-modifying antirheumatic drugs (DMARDs) and radiographic distal interphalangeal-(DIP) OA in patients with RA. Methods Adult RA patients from a longitudinal Swiss registry of rheumatic diseases who had ≥ 2 hand radiographs were included at the first radiograph and followed until the outcome or the last radiograph. Patients were grouped into two cohorts based on whether DIP OA was present or absent at cohort entry (cohorts 1 and 2, respectively). Modified Kellgren-Lawrence scores (KLS) were obtained by evaluating DIP joints for the severity of osteophytes, joint space narrowing, subchondral sclerosis, and erosions. KLS ≥ 2 in ≥ 1 DIP joint indicated incident or existing OA, and increase of ≥ 1 in KLS in ≥ 1 DIP joint indicated progression in existing DIP OA. Time-varying Cox regression and generalized estimating equation (GEE) analyses were performed. We estimated hazard ratios (HRs) and odds ratios (ORs) with 95% confidence intervals (CI) of DIP OA incidence (cohort 2), or progression (cohort 1), in bDMARD monotherapy, bDMARD/csDMARD combination therapy, and past or never DMARD use, when compared to csDMARD use. In post hoc analyses, we descriptively and analytically assessed the individual KLS features in cohort 1. Results Among 2234 RA patients with 5928 radiographs, 1340 patients had DIP OA at baseline (cohort 1). Radiographic progression of DIP OA was characterized by new or progressive osteophyte formation (666, 52.4%), joint space narrowing (379, 27.5%), subchondral sclerosis (238, 17.8%), or erosions (62, 4.3%). bDMARD monotherapy had an increased risk of radiographic DIP OA progression compared to csDMARD monotherapy (adjusted HR 1.34 [95% CI 1.07–1.69]). The risk was not significant in csDMARD/bDMARD combination users (HR 1.12 [95% CI 0.96–1.31]), absent in past DMARD users (HR 0.96 [95% CI 0.66–1.41]), and significantly lower among never DMARD users (HR 0.54 [95% CI 0.33–0.90]). Osteophyte progression (HR 1.74 [95% CI 1.11–2.74]) was the most significantly increased OA feature with bDMARD use compared to csDMARD use. In 894 patients without initial DIP OA (cohort 2), the risk of incident OA did not differ between the treatment groups. The results from GEE analyses corroborated all findings. Conclusions These real-world RA cohort data indicate that monotherapy with bDMARDs is associated with increased radiographic progression of existing DIP OA, but not with incident DIP OA.

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Convolutional Neural Network-Based Automatic Measurement of Joint Space Width to Predict Radiographic Severity and Progression of Knee Osteoarthritis

10.21203/rs.3.rs-221004/v1 ◽

2021 ◽

Author(s):

James Chung Wai Cheung ◽

Yiu Chow TAM ◽

Lok Chun CHAN ◽

Ping Keung CHAN ◽

Chunyi WEN

Keyword(s):

Neural Network ◽

Knee Osteoarthritis ◽

Convolutional Neural Network ◽

Pearson Correlation ◽

Joint Space Width ◽

Joint Space ◽

Receiver Operating Curve ◽

Radiographic Severity ◽

X Ray ◽

Space Width

Abstract Objectives To develop a deep convolutional neural network (CNN) for the segmentation of femur and tibia on plain x-ray radiographs, hence enabling an automated measurement of joint space width (JSW) to predict the severity and progression of knee osteoarthritis (KOA). Methods A CNN with ResU-Net architecture was developed for knee X-ray imaging segmentation. The efficiency was evaluated by the Intersection over Union (IoU) score by comparing the outputs with the annotated contour of the distal femur and proximal tibia. By leveraging imaging segmentation, the minimal and multiple JSWs in the tibiofemoral joint were estimated and then validated by radiologists’ measurements in the Osteoarthritis Initiative (OAI) dataset using Pearson correlation and Bland–Altman plot. The estimated JSWs were deployed to predict the radiographic severity and progression of KOA defined by Kellgren-Lawrence (KL) grades using the XGBoost model. The classification performance was assessed using F1 and area under receiver operating curve (AUC). Results The network has attained a segmentation efficiency of 98.9% IoU. Meanwhile, the agreement between the CNN-based estimation and radiologist’s measurement of minimal JSW reached 0.7801 (p < 0.0001). Moreover, the 32-point multiple JSW obtained the highest AUC score of 0.656 to classify KL-grade of KOA. Whereas the 64-point multiple JSWs achieved the best performance in predicting KOA progression defined by KL grade change within 48 months, with AUC of 0.621. The multiple JSWs outperform the commonly used minimum JSW with 0.587 AUC in KL-grade classification and 0.554 AUC in disease progression prediction. Conclusion Fine-grained characterization of joint space width of KOA yields comparable performance to the radiologist in assessing disease severity and progression. We provide a fully automated and efficient radiographic assessment tool for KOA.

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