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Grading Osteoarthritic Changes of the Zygapophyseal Joints from Radiographs: A Reliability Study

Grading Osteoarthritic Changes of the Zygapophyseal Joints from Radiographs: A Reliability Study

Authors :
Joshua W. Little
Joseph P.D. Stiefel
Evelyn Laptook
Kathleen L. Linaker
Thomas J. Grieve
Gregory D. Cramer
Jeffrey A. Rich
Source :
Journal of Manipulative and Physiological Therapeutics. 38:344-351
Publication Year :
2015
Publisher :
Elsevier BV, 2015.

Abstract

Objective This study tested the reliability of a 5-point ordinal scale used to grade the severity of degenerative changes of zygapophyseal (Z) joints on standard radiographs. Methods Modifications were made to a Kellgren grading system to improve agreement for grading the severity of osteoarthritic changes in lumbar Z joints. These included adding 1 grade of no degeneration, multiple radiographic views, and structured examiner training. Thirty packets of radiographic files were obtained, which included representation of all 5 grades including no degeneration (0) and Kellgren's 4-point (1-4) joint degeneration classification criteria. Radiographs were digitized to create a radiographic atlas that was given to examiners for individual study and blinded evaluation sessions. Intrarater and interrater agreement was determined by weighted κ ( κ w ) from the examination of 79 Z joints (25 packets). Results Using the modified scale and after training, examiners demonstrated a moderate-to-substantial level of interrater agreement ( κ w = 0.57, 0.60, and 0.68). Intrarater agreement was moderate ( κ w = 0.42 and 0.54). Conclusions The modified Kellgren 5-point grading system provides acceptable intrarater and interrater reliability when examiners are adequately trained. This grading system may be a useful method for future investigations assessing radiographic osteoarthritis of the Z joints.

Details

ISSN :
01614754
Volume :
38
Database :
OpenAIRE
Journal :
Journal of Manipulative and Physiological Therapeutics
Accession number :
edsair.doi.dedup.....9b908f506d8b96e4f201326c2454810c
Full Text :
https://doi.org/10.1016/j.jmpt.2014.12.009