Automated Measurement of joint space width in small joints of patients with rheumatoid arthritis

C. Lukas, D.A. Gordon (Editor), J.T. Sharp, J. Angwin, M. Boers, J. Duryea, J.R. Hall, J.A. Kauffman, R. Landewe, G. Langs, H.J. Bernelot Moens, P. Peloschek, D. van der Heijde

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    15 Citations (Scopus)


    Objective. Comparison of performances of 5 (semi)automated methods in measuring joint space width (JSW) in rheumatoid arthritis. Methods. Change in JSW was determined by 5 measurement methods on 4 radiographs per patient from 107 patients included in the COBRA trial (comparing sulfasalazine alone or in combination with methotrexate and corticosteroids). For each method the number of patients with sufficient available results was assessed (efficiency). An independent repeated measurement was carried out on a random sample of 30 patients' baseline and 1-year radiographs, to evaluate within-method reliability of change scores. Discriminatory ability (DA) of the measurement methods (between the 2 treatment arms) was compared with the DA of the Sharp-van der Heijde score (SHS) and its 2 components (erosion and JSW scores). Results. The overall success rate varied widely between methods. Applying the chosen threshold of a minimum of 50% available joints with a change score per patient resulted in a success rate > 92% in 4/5 methods. Repeatability of measurements was good for most methods (intraclass correlation coefficient ≥ 0.80 in 4/5 methods). Almost all measurement methods in 3 followup periods (12/14) showed a lower mean loss of JSW in patients from the intensive treatment group, although this was rarely statistically significant, confirming the known difference in structural damage. JSW as measured by the (semi)automated systems often showed higher DA than the JSW score of the SHS, but was lower than the total SHS and erosion scores. Conclusion. Although efficiency of the methods should be improved further, results already show good reliability and encouraging DA of most methods. Optimal information may be obtained with a combination of scoring of erosions and (semi)automated measurement of JSW. (First Release June 15 2008; J Rheumatol 2008;35:1288-93)
    Original languageEnglish
    Pages (from-to)1288-1293
    Number of pages6
    JournalJournal of rheumatology
    Issue number7
    Publication statusPublished - 15 Jun 2008


    • EWI-13885
    • CR-I.4
    • METIS-255953
    • IR-62503


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