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Biomedical subjects

J C Buckland-Wright

Publications and source records attributed to J C Buckland-Wright.

At least 37 records · Page 2Linked to original sources
PubMed1995

Joint space width measures cartilage thickness in osteoarthritis of the knee: high resolution plain film and double contrast macroradiographic investigation.

OBJECTIVE: To test reliability of joint space width (JSW) measurements as a predictor of cartilage thickness in knees of patients with osteoarthritis (OA), using high definition microfocal radiography. METHOD: JSW was measured from weight bearing plain film macroradiographs taken in the tunnel view and compared with the sum of femoral and tibial cartilage thicknesses measured from double contrast macroarthrograms of the same regions of the same knees obtained in the non-weight bearing lateral position. RESULTS: All knees had medial compartment OA. Comparison of the JSW with the sum of the tibial and femoral cartilage thicknesses revealed a highly significant correlation (p < 0.0001) between the two measurements in the medial but not the lateral compartment. In the middle region of both compartments, JSW was smaller than the cartilage thickness, indicating that, on standing, the curvature of the femoral condyles compressed the cartilage in this region. CONCLUSIONS: JSW reliably measured cartilage thickness in the medial but not the lateral compartment of knees with medial compartment OA. Depending upon the stage of OA disease, JSW reliably reflects cartilage thinning and compression.

Adult↗
PubMed1995

Sensitivity of radiographic features and specificity of scintigraphic imaging in hand osteoarthritis.

We undertook to determine which of the radiographic features most reliably detected the presence and disease progression in osteoarthritis in the hand; and which of the radiographic features corresponded with the radionuclide bone scan images. 32 patients with osteoarthritis had X 5 macroradiographs taken of their wrists and hands at 6 monthly intervals over an 18 month period. The high magnification and resolution of microfocal radiography permitted quantitative detection of the extent and change in joint space width, subchondral sclerosis, osteophytosis and juxtaarticular radiolucencies. 4-hour technetium 99m methylene bisphosphonate bone scans were taken at 0 and 12 months and the activity of the tracer uptake at each joint scored. The latter was compared with the radiographic features at each visit and the changes between visits analysed. In hand OA the most sensitive radiographic parameters for detecting disease were osteophytes, subchondral sclerosis and juxtaarticular radiolucencies, with radionuclide imaging demonstrating the increased activity in bone formation associated with the growth and remodelling of osteophytes. Changes in the number and size of osteophytes and joint space narrowing were the only reliable and sensitive parameters for assessing disease progression. We conclude that in osteoarthritis, the bony changes progress significantly before the occurrence of radiographically evident joint space narrowing indicative of cartilage thinning.

Adult↗
PubMed1995

Quantitative microfocal radiography detects changes in OA knee joint space width in patients in placebo controlled trial of NSAID therapy.

OBJECTIVE: To assess the usefulness of, and define the time course of changes in the features of osteoarthritic (OA) knees measurable using microfocal radiography, and to determine whether it differs in patients taking a nonsteroidal antiinflammatory drug (NSAID). METHODS: Forty-five patients with knee OA were randomly allocated to receive either diclofenac sodium or placebo for 18 months; 33 (17 NSAID, 16 placebo) completed the study. Clinical and 5 x high definition macroradiographic assessments of both knees in standing semiflexed views were carried out at 6-monthly intervals. Precise measurements were taken of the tibial and femoral subchondral thickness and osteophyte size, and of joint space width (JSW) across the narrowest part of the medial and lateral tibiofemoral compartments. RESULTS: In all knees as a group, there was no statistically significant difference in JSW between treatment groups. However, changes in JSW were significantly different (p < 0.04, multivariate analysis of variance) between treatments in 51 knees with early disease, i.e., those with initially > 50% JSW (22 active, 29 placebo), but not in 15 knees with severe disease, i.e., initially < 50% JSW (10 active, 5 placebo). During the study, osteophyte size in all knees and in those with > 50% JSW increased significantly (p < 0.016; p < 0.008) in the placebo group but remained unchanged in the treatment group. No significant changes were detected in subchondral cortical thickness. CONCLUSION: Using microfocal radiography the time course of changes in JSW and osteophyte size of knees with early, but not late OA, was found to differ in both pattern and magnitude in patients receiving NSAID: In knees with late stage OA the JSW progressively decreased irrespective of treatment. The observations may prove useful for the design of future therapeutic trials.

Adult↗
PubMed1994

Fractal signature analysis of macroradiographs measures trabecular organization in lumbar vertebrae of postmenopausal women.

High definition macroradiography was used to provide an image of the detailed structural organization of the cancellous bone in human lumbar vertebrae. The fractal signature analysis (FSA) method was used to quantify the horizontal and vertical trabecular organization recorded within the image. Comparison of the FSA of the postero-anterior and lateral macroradiographs in postmortem lumbar vertebrae showed that neither the superimposition of the neural arch nor the radiographic angle affected the trabecular measurement within the vertebral body. FSA analysis of the trabecular structure measured from the macroradiographs of lumbar vertebrae in two groups of postmenopausal women, with high and low bone mineral density (BMD), showed that the large vertical trabecular structures correlated with the women's body weight (P < 0.01-0.03) and body mass index (P < 0.005-0.05), the fine horizontal structures correlated with the women's age (P < 0.005-0.05), and fine vertical trabecular structures were significantly greater (P < 0.005-0.05) in the low compared with the high BMD group.

Adult↗
PubMed1994

Symmetry of radiological features in the wrist and hands of patients with early to moderate rheumatoid arthritis: a quantitative microfocal radiographic study.

Quantitative microfocal radiography was used to assess the degree of symmetry in radiological features between the dominant and non-dominant wrist and hands of 51 patients with early to moderately advanced RA. With few exceptions, erosion size and joint space width were bilaterally symmetrical between the dominant and non-dominant side in: total erosion area and total joint space width; area at each of the separate sites of erosion formation, and width at each joint space; and the change in these X-ray features over an 18-month study period. Asymmetry in the number and size of erosions and joint space occurred in a small number of patients within either extremity; these differences were not sustained over the study period. In view of this degree of bilateral symmetry, the extent and progression of the radiographic features in RA can be assessed from a single macroradiograph of either the left or right wrist and hand.

Adult↗
PubMed1994

Quantitative microfocal radiographic assessment of osteoarthritis of the knee from weight bearing tunnel and semiflexed standing views.

OBJECTIVE: Joint space width (JSW) in osteoarthritis (OA) knee radiography is reported to be optimally assessed from semiflexed standing and tunnel views although no detailed assessment of tunnel view radiography of OA knees has been done. The primary objective of our study was to determine the incidence of joint space narrowing (JSN) in semiflexed standing vs weight bearing tunnel views. The data were also analyzed to examined the degree and relationship of JSN and bony features of OA in the 2 views. METHODS: Ninety OA knees had macroradiographs at 5 times magnification taken in weight bearing standing semiflexed and weight bearing tunnel views. JSW and OA related bony features were measured and compared with reference values obtained from the knees of 14 healthy volunteers without arthritis. RESULTS: Comparison of JSW between the 2 radiographic views identified 3 locations of cartilage loss: JSN recorded in the tunnel only (22%), that in standing view only (8%), and that in both the views (30%). Subchondral sclerosis and osteophytes were significantly larger in 40% of OA knees despite a normal JSW. The tunnel view also enabled better visualization and measurement of osteophytes. CONCLUSION: Standing semiflexed view radiography alone failed to detect JSN in 22% of OA knees. Combined standing and tunnel radiographic views detected JSN more frequently than either view alone. Bony changes were radiographically evident without the presence of JSN indicative of cartilage thinning in as many as 40% of the patients with OA studied.

Aged↗
PubMed1993

Precision of joint space width measurement in knee osteoarthritis from digital image analysis of high definition macroradiographs.

The precision of joint space width (JSW) measurements from plain film radiographs of the knee is limited by poor radio-anatomical positioning of the joint and/or insensitive methods of measurement. These limitations were overcome by establishing a precise radio-anatomical position for standing loaded and weight-bearing tunnel views of the knee, using the advantages of high definition macroradiography and a new computerized method for automatic JSW measurement from digitized macroradiographs of the knee. Reproducibility of JSW measurements was obtained from macroradiographs of knees of five post-mortem subjects and 12 patients with osteoarthritis (OA). JSW measurements were altered more by vertical than by horizontal misalignment of the X-ray beam relative to the joint space. In OA knees with medial compartment involvement, JSW measurements were more reproducible in the medial than lateral compartments in both radiographic views. In the medial compartment, the coefficient of variation for joint repositioning was 1% for minimum and 2% for average JSW, and for inter- and intraobserver errors, it was < 1% for both JSW measurements. The precision of this method will permit quantification of changes in JSW associated with disease progression and the treatment of OA.

Aged↗
PubMed1993

A study of the early and late 99technetium scintigraphic images and their relationship to symptoms in osteoarthritis of the hands.

Thirty-five patients with OA of the hands had an early and late phase isotope bone scan performed at entry and 1 yr later. Simultaneous assessment of symptoms was made by a visual analogue pain score (VAS) and a tender joint articular index (AI) and comparisons were made between the clinical and scintigraphic findings. Sixty-five percent of joints were classed as positive in the late phase compared to 17% in the early phase scan. Thirteen per cent of joints were positive only in the early phase and 49% only in the late phase. There was no significant overall change in either phase of the scan in 1 yr. The pattern of positive joints showed considerable symmetry and wrist involvement. There was a high degree of correlation between AI and the late phase scan but none with the early phase scan. VAS showed no correlation with the late phase scan but did correlate significantly with the early phase scan at 1 yr.

Aged↗
PubMed1993

Quantitative microfocal radiography detects changes in erosion area in patients with early rheumatoid arthritis treated with myocrisine.

Patients with early rheumatoid arthritis (RA) were randomly divided into those receiving gold early (n = 13) or 6 months later (n = 10). They were followed 6 monthly over 18 months. Mean erosion area in gold and delayed gold, measured from macroradiographs, was comparable at baseline and increased significantly over the first 6 months. In the second 6 months, gold showed no increase and delayed gold an insignificant increase. By the third 6 months both groups showed a decrease. On comparing the second 6 months of gold therapy in gold and delayed gold with a group of patients with RA of similar disease duration (n = 34) not receiving gold, a lower proportion (p < 0.005) had erosion area progression and a higher proportion (p < 0.001) erosion repair.

Adult↗
PubMed1992

Relationship between joint space width and subchondral sclerosis in the osteoarthritic hand: a quantitative microfocal radiographic study.

Measurement of joint space width and subchondral sclerosis from x 5 macroradiographic examination of 32 patients with osteoarthritis (OA) of the hand over an 18-month period showed that joint space loss was symmetrical in both hands. Its change showed that over a period of time narrowing progressed proximally from distal interphalangeal to proximal interphalangeal, metacarpalphalangeal and wrist joints. Sclerosis was greatest in those joints at which the largest forces were exerted across the hand in precision, power and pulp-pinch grip, respectively. Our findings suggest that constitutional factors determine the onset of cartilage changes in OA which in turn result in subchondral sclerosis, the extent of which is determined by the pattern of normal forces within the hand.

Aged↗
PubMed1991

Techetium 99m methylene diphosphonate bone scanning in osteoarthritic hands.

In this prospective study, the radiological features characteristic of osteoarthritis of the hand were compared with the radionuclide bone scan images. A total of 32 patients was assessed at 6-monthly intervals for 18 months. Microfocal radiographs were taken at each visit. The high magnification and resolution of this technique permitted direct measurement of joint space width, subchondral sclerosis, osteophyte number and area and juxta-articular radiolucency area for each joint in the hand. Four-hour technetium 99m methylene diphosphonate bone scans were taken at 0 and 12 months and the activity of tracer uptake at each joint scored. The latter was compared with each X-radiographic feature at every visit and the changes between visits analysed. The scan scores did not correlate with any of the X-radiographic features other than osteophyte size. During the study the size of growing and remodelling osteophytes increased significantly at joints with raised or increased isotope uptake.

Female↗
PubMed1991

Analysis of texture in macroradiographs of osteoarthritic knees using the fractal signature.

Texture of regions of macroradiographs (x5) of six normal and five osteoarthritic knee joints, taken on a high resolution microfocal x-ray unit, are examined using mathematical morphology. Radiographs of bones are two-dimensional projections of attenuation coefficient through the three-dimensional (3D) joint structure. Visible texture represents the summation of the attenuation from numerous thin plates of bone. Where there is no organization in the trabeculae, resultant radiographs approximate a fractal surface. Varying structuring element size in mathematical morphology allows estimation of fractal dimension over a range of resolution. Variation of fractal dimension with resolution, the fractal signature, indicates how images deviate from fractal surfaces. By correct choice of structuring element, a texture analysis method using the fractal signature has been developed, tolerant to changes in image acquisition and digitization. Texture in regions of radiographs of normal tibia approximates a fractal surface with dimension 2.8 as does vertical structure in arthritic patients. In osteoarthritic knee joints, horizontal tibial trabeculae thicken. Horizontal structure in the tibia on radiographs of arthritic patients deviates from the fractal model. This is indicated by peaks in the fractal signature whose height and position match a visual assessment of the degree of arthritic change.

Humans↗
PubMed1991

Comparison of clinical, radionuclide, and radiographic features of osteoarthritis of the hands.

Simultaneous clinical, scintigraphic, and macroradiographic assessments were carried out on 32 patients with hand osteoarthritis and the results at entry and one year reported. The presence and growth of osteophyte correlated with symptoms and a positive scan. The scan did not detect the radiographic features of juxta-articular radiolucencies, subchondral sclerosis, or cartilage thinning. Osteophytes, particularly when fast growing, produce pain, a 'hot' scan, and may predict disintegration of joint architecture.

Arthrography↗