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A comparative analysis of automatic classification and grading methods for knee osteoarthritis focussing on X-ray images

Saini Deepak, Chand Trilok, Chouhan Devendra K., Prakash Mahesh

Biocybernetics and Biomedical Engineering

2021

Vol. 41, no. 2

419--444

Objective: The purpose of present review paper is to introduce the reader to key directions of manual, semi-automatic and automatic knee osteoarthritis (OA) severity classification from plain radiographs. This is a narrative review article in which we have described recent developments in severity evaluation of knee OA from X-ray images. We have primarily focussed on automatic analysis and have reviewed articles in which machine learning, transfer learning, active learning, etc. have been employed on X-ray images to access and classify the severity of knee OA. Methods: All original research articles on OA detection and classification using X-ray images published in English were searched on PubMed database, Google Scholar, RSNA radiology databases in year 2019. The search terms of ‘‘knee Osteoarthritis” were combined with search terms ‘‘Machine Learning”, ‘severity” and ‘‘X-ray”. Results: The initial search on various publication databases revealed a total of 743 results, out of which only 26 articles were considered relevant to radiographic knee OA severity analysis. The majority of the articles were based on automatic analysis. Manual segmentation based articles were least in numbers. Conclusion: Computer aided methods to diagnose knee OA are great tools to detect OA at ealry stages. Advancements in Human Computer Interface systems have led the researchers to bridge the gap between machine learning algorithms and expert healthcare professionals to provide better and timely treatment options to the knee OA affected patients.

Effect of sound on standing postural stability in the elderly with and without knee osteoarthritis

Hengsomboon Pichaya, Hiengkaew Vimonwan, Hsu Wei-Li, Bovonsunthonchai Sunee

Acta of Bioengineering and Biomechanics

2019

Vol. 21, no. 3

99--108

The aim of the study was to investigate the influence of sound on standing postural control in the elderly with and without knee osteoarthritis (knee-OA). Methods: Twenty-six elderly with knee-OA and 26 elderly without knee-OA who matched the age and height participated in this study. The standing postural stability was assessed by the 3D motion analysis system. Four testing conditions of the combination of sound (no sound and white noise sound) and surface (firm and soft surfaces) were tested three times with eyes closed for 30 sec. Postural stability variables included the standard deviation and velocity of the centre of pressure, the total body centre of mass, and centre of the head along the antero-posterior (AP) and medio-lateral (ML) directions. Results: Statistical significant reductions of all variables along ML direction were found in the elderly without a knee-OA in the presence of sound during standing on a firm surface. No significant effect of sound was found in the elderly with the knee-OA during standing on a firm surface. In the standing on a soft surface, both groups demonstrated no significant effect of sound on all postural stability variables. Conclusions: Application of sound improved the standing postural stability in the frontal plane for the elderly without knee-OA. However, the effect of sound was limited in standing on a soft surface for both elderly with and without knee-OA.

Analysis of the connection between pain, disability and a radiological image determining the treatment process

Mańko G., Kuśnierczyk A., Pieniążek M., Kurzydło W.

Polish Hyperbaric Research

2016

nr 3(56)

53--62

The objective of this paper is to analyse the correlation between pain and the degree of disability, and the lesions shown on radiological examination of KOA. Material and method: The study encompassed 31 female patients (42 knees) aged 51-70 years, with diagnosed idiopathic knee osteoarthritis. Medical history and analysis of previously performed x-ray scans were conducted. The history included questions regarding pain (VAS, WOMAC index) and the maximum marching distance, the presence of oedema and instability as well as disability in everyday life (WOMAC index). The radiological lesions were assessed using the Kellgren and Lawrence Grading Scale. Moreover, the widths of the joint spaces were measured. Results: The patients’ pain in everyday activities (WOMAC) showed a positive correlation with the presence of osteophytes (r=0.32), and the intensity of the pain on the VAS correlated with the presence of joint osteophytes (r=0.46) and with the elevation of the intercondylar eminence (r=0.32). The other disorders on the x-ray image did not correlate with the pain. Positive correlations were identified between the presence of oedema (r=0.57) and instability (r=0.39), and the presence of lesions in the patellofemoral joint. The patients’ disability in everyday activities (WOMAC) showed a negative correlation with the width of the joint spaces (r<-0.34). However, no correlations were observed between the remaining x-ray lesions and the WOMAC index. Conclusions: Only a small number of subjects showed a correlation indicating an interdependency between the painful sensations and the degree of disability versus the progression of radiographic lesions. Among the KOA risk factors, it is worth noting the presence of obesity which, in these studies, affected more than half of the female patients.

Celem pracy jest analiza zależności pomiędzy dolegliwościami bólowymi i stopniem niesprawności a zmianami wykazanymi w radiologicznym badaniu ChZSK. Materiał i metoda: Przebadano 31 pacjentek (42 kolana) w wieku 51-70 lat z rozpoznaną idiopatyczną chorobą zwyrodnieniową stawu kolanowego. Przeprowadzono wywiad i ocenę uprzednio wykonanego zdjęcia rtg. W wywiadzie zawarte były pytania dotyczące bólu (skala VAS, indeks WOMAC) oraz maksymalnego dystansu marszem, występowania obrzęku i niestabilności oraz niesprawności w życiu codziennym (indeks WOMAC). Zmiany radiologiczne oceniono wg skali Kallgren’a i Lavrence’a. Ponadto zmierzono również szerokości szpar stawowych. Wyniki: Ból pacjentek w czynnościach codziennych (WOMAC) korelował dodatnio obecnością osteofitów (r=0,32) a intensywność odczuwanego bólu w skali VAS korelowała z obecności osteofitów w stawie (r=0,46) oraz z uniesieniem wyniosłości międzykłykciowej (r=0,32). Pozostałe zaburzenia w obrazie rtg nie korelowały z bólem. Zauważono dodatnie korelacje pomiędzy występowaniem obrzęku (r=0,57) i niestabilności (r=0,39) a obecnością zmian w stawie rzepkowo-udowym. Niesprawność pacjentek w czynnościach codziennych (WOMAC) korelowała ujemnie z szerokością szpar stawowych (r<-0,34). Natomiast pomiędzy pozostałymi zmianami w rtg a wskaźnikiem WOMAC nie zanotowałam korelacji. Wnioski: Jedynie u niewielkiej liczby badanych wystąpiła korelacja wskazująca na zależność pomiędzy odczuciami bólu istopniem niesprawności, a zaawansowaniem zmian wykazanych w radiogramach. Spośród czynników ryzyka ChZSK warto zwrócić uwagę na obecność otyłości, która w przedstawionych badaniach wystąpiła u ponad połowy pacjentek.