Quantitative joint space width sensitive to change, linked to hip osteoarthritis in women
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Semi-automated quantitative joint space width at the 50-degree location is sensitive to change as a measure of hip joint space over time, and is associated with hip osteoarthritis in women, according to data.
The researchers, who published their findings in Arthritis Care & Research, additionally concluded that only baseline quantitative joint space width was predictive of hip OA in men.
“As a continuous, objective and reproducible measure, quantitative joint space width (qJSW) is likely to be more responsive to change over time than subjective categorical measures such as the Kellgren-Lawrence grade (KLG) or individual grades of osteophytes or joint space narrowing,” Amanda E. Nelson, MD, MSCR, of the University of North Carolina at Chapel Hill, told Healio Rheumatology. “Having a reliable measure of loss of joint space over time is important to assess development or worsening osteoarthritis in longitudinal settings.”
To examine the association between qJSW, at 10-, 30- and 50-degree locations, and radiographic and symptomatic hip osteoarthritis, Nelson and colleagues analyzed data from the Johnston County OA Project, based in North Carolina. According to the researchers, the project is a longitudinal study of civilian, non-institutionalized Black and white men and women who were aged 45 years or older at baseline, resided in one of six designated townships in Johnston County for at least 1 year, and were physically and mentally capable of study completion at baseline.
For this study, Nelson and colleagues identified participants with a complete set of standardized, longitudinal, supine anteroposterior pelvis radiographs at baseline — from 1991 to 1997 — and three subsequent time points — 1999 to 2003, 2006 to 2011, and 2013 to 2015. All visits were approximately 6 years apart. An expert radiologist assigned a KLG to all hips. An independent examiner, blinded to other radiographic and clinical information, performed the qJSW measurements at 10-, 30- and 50- degrees with respect to a polar coordinate system.
In all, Nelson and colleagues analyzed data on 784 hips from 397 patients, of whom 41% were men. At baseline, the mean age was 57 years and the mean BMI was 29 kg/m2. The researchers used sex-stratified and multivariable-adjusted linear mixed models to assess covariates — including age, race, height, weight and BMI — associated with qJSW, as well as hip-level associations between qJSW and hip OA, over time. In addition, they used a cluster analysis with logistic regression to estimate associations between qJSW trajectory groups and incident radiographic and symptomatic hip OA.
In all, 20% and 12% of participants developed incident KLG-defined radiographic hip OA over a mean of 18 years, while 12% demonstrated symptomatic hip OA over the same period.
According to the researchers, qJSW was more sensitive to changes over time at 50 degrees. Values were stable among men but fell over time in women, with heavier women losing more qJSW. Meanwhile, changes in qJSW were not significantly associated with race, education or injury in women or men. Loss of qJSW over time was associated with two to three times higher odds of radiographic and symptomatic hip OA in women only. However, narrower baseline qJSW was associated with these outcomes in men and women, the researchers wrote.
“We found that quantitative joint space width measured at the 50-degree location was sensitive to change, demonstrated a decline over time, and was associated with development of hip osteoarthritis in women,” Nelson said. “Men demonstrated stable values of quantitative joint space width over time (ie, they did not lose joint space width), but their baseline values were predictive of incident hip osteoarthritis.”
She added: “These findings reinforce the importance of sex differences in hip OA and highlight the utility of objective continuous measurement of hip joint space width over time as a sensitive measure associated with hip OA.”
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