Atlas of individual radiographic features in osteoarthritis, revised.

OBJECTIVE: Develop a radiographic atlas of osteoarthritis (OA) to be used as a template and guide for grading radiographs of osteoarthritic lesions of the hand, hip and knee.
METHOD: The 1995 atlas was reviewed for the images most useful for clinical trials. Replacement images were selected from the Stanford University Radiology Department Picture Archive and Communications System by reviewing consecutive radiographs obtained from patients. Selected images were downloaded without patient identification information. Images were organized by hand, hip and knee. They were reviewed for findings of OA and images grouped into image files by individual findings and degree of change. Both investigators individually selected the most promising images. Final images were selected by consensus. Original electronic images were then cropped and placed in sequence.
RESULTS: Individual radiographic features (e.g., osteophytes, joint space narrowing) were recorded for hand (distal interphalangeal joint, proximal interphalangeal joint, trapeziometacarpal joint), hip (acetabular, femoral) and knee (medial compartment, lateral compartment, tibial, femoral); they were also sequenced for normal, 1+, 2+, and 3+ change. Images were made available in print and electronic formats.
CONCLUSION: An updated atlas of radiographic images was produced to assist in grading individual radiographic features of the hand, hip and knee for clinicians and for use in clinical trials.