Evidence map›Paper›PMID 42239637›Full record

ArticleOsteoarthritis imaging2025

Impact of quantified knee positioning on the measurement of minimal joint space width using statistical shape models: A cross-sectional and longitudinal analysis in the IMI-APPROACH.

Eva A Bax, H Chien Nguyen, Roel J H Custers, Vahid Arbabi, Hassan Rayegan, Willem Paul Gielis, Claudia Lindner, Tim F Cootes, Margreet Kloppenburg, Francisco J Blanco and 9 more

Abstract read
In one paragraph

Article in Osteoarthritis imaging, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Eva A BaxDepartment of Orthopaedic Surgery, University Medical Center Utrecht, the Netherlands.
H Chien NguyenDepartment of Orthopaedic Surgery, University Medical Center Utrecht, the Netherlands.
Roel J H CustersDepartment of Orthopaedic Surgery, University Medical Center Utrecht, the Netherlands.
Vahid ArbabiDepartment of Orthopaedic Surgery, University Medical Center Utrecht, the Netherlands.
Hassan RayeganDepartment of Mechanical Engineering, Bozorgmehr University of Qaenat, Iran.
Willem Paul GielisDepartment of Orthopaedic Surgery, University Medical Center Utrecht, the Netherlands.
Claudia LindnerDivision of Informatics, Imaging and Data Sciences, The University of Manchester, United Kingdom.
Tim F CootesDivision of Informatics, Imaging and Data Sciences, The University of Manchester, United Kingdom.
Margreet KloppenburgDepartments of Rheumatology, Clinical Epidemiology, Leiden University Medical Center, the Netherlands.
Francisco J BlancoGrupo de Investigación de Reumatologia (GIR), INIBIC-Complejo Hospitalario Universitario de A Coruña, Centro Interdisciplinar de Quimica y Biologia, CICA-UDC, Universidad de A Coruña, Spain.
Ida K HaugenCenter for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Norway.
Francis BerenbaumDepartment of Rheumatology, Sorbonne University, INSERM CRSA, AP-HP Saint-Antoine Hospital, France.
Mylène P JansenDepartment of Rheumatology & Clinical Immunology, University Medical Center Utrecht, the Netherlands.
Simon C MastbergenDepartment of Rheumatology & Clinical Immunology, University Medical Center Utrecht, the Netherlands.
Frank W RoemerDepartment of Radiology, Universitätsklinikum Erlangen & Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Germany.
Felix EcksteinResearch Program for Musculoskeletal Imaging, Center for Anatomy & Cell Biology and Ludwig Boltzmann Institute for Arthritis & Rehabilitation, Paracelsus Medical University Salzburg, Austria.
Wolfgang WirthResearch Program for Musculoskeletal Imaging, Center for Anatomy & Cell Biology and Ludwig Boltzmann Institute for Arthritis & Rehabilitation, Paracelsus Medical University Salzburg, Austria.
Moyo C KruytDepartment of Orthopaedic Surgery, University Medical Center Utrecht, the Netherlands.
Harrie WeinansDepartment of Orthopaedic Surgery, University Medical Center Utrecht, the Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: Correlations between minimum joint space width (mJSW) and MRI-based cartilage thickness are strong in cross-sectional analyses and moderate in longitudinal analyses, possibly due to knee rotation and flexion. This study investigates the effect of knee positioning during radiographic acquisition on the difference between mJSW and MRI-based cartilage thickness. Methods: Radiographic mJSW from the index knee was determined from baseline (265 patients) and 24-month follow-up (165 patients) on fixed-flexion radiographs from IMI-APPROACH (multicenter OA study) patients using automated software. Statistical Shape Models were used to quantify knee rotation and flexion on radiographs. Cartilage thickness was assessed by manual segmentation from MRI. Differences between mJSW (radiographs) and cartilage thickness (MRI) were assessed at baseline and follow-up. Multivariable linear regression was used to evaluate the impact of knee flexion and rotation on the difference between mJSW and cartilage thickness. Results: In cross-sectional analysis, differences between X-ray and MRI were significantly influenced by knee rotation (β = -0.18, P < 0.001). Longitudinal change in differences between X-ray and MRI were associated with changes in knee flexion (β = 0.19, P=0.002). Increases of one standard deviation in internal rotation and extension at follow-up resulted in a 0.2 mm false surrogate measurement of cartilage changes on radiographs. Conclusion: Quantified knee positioning significantly affects differences between mJSW measured on radiographs and MRI-based cartilage thickness. The longitudinal analyses revealed that knee flexion was related to these differences, while knee rotation was only related to cross-sectional differences. These findings highlight the importance of knee positioning during radiographic acquisition in contributing to false surrogate measurement of cartilage status and cartilage change.

Indexed as

Cartilage thicknessKnee osteoarthritisKnee positioningMinimum joint space widthStatistical shape models

Identifiers

PMID42239637
PMCPMC13228718

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.