A novel classifier of radiographic knee osteoarthritis for use on knee DXA images is predictive of joint replacement in UK Biobank
A novel classifier of radiographic knee osteoarthritis for use on knee DXA images is predictive of joint replacement in UK Biobank
Objectives: DXA scans may offer a novel means of evaluating radiographic knee OA (rKOA) in large population studies and through opportunistic screening. We aimed to develop and apply a semi-automated method for assessing rKOA using ≈20 000 knee DXA images from UK Biobank (UKB) and assess its face validity by checking for expected relationships with clinical outcomes.
Methods: right knee DXA scans were manually annotated for osteophytes to derive corresponding grades. Joint space narrowing (JSN) grades in the medial joint compartment were determined from automatically measured minimum joint space width. Overall rKOA grade (0-4) was determined by combining osteophyte and JSN grades. Logistic regression was employed to investigate the associations of osteophyte, JSN and rKOA grades with knee pain and hospital-diagnosed KOA. Cox proportional hazards modelling was used to examine the associations of these variables with risk of subsequent total knee replacement (TKR).
Results: of the 19 595 participants included (mean age 63.7 years), 19.5% had rKOA grade ≥1 (26.1% female, 12.5% male). Grade ≥1 osteophytes and grade ≥1 JSN were associated with knee pain, hospital-diagnosed KOA and TKR. Higher rKOA grades were linked to stronger associations with these clinical outcomes, with the most pronounced effects observed for TKR. Hazard ratios for the association of rKOA grades with TKR were 3.28, 8.75 and 28.63 for grades 1, 2 and 3-4, respectively.
Conclusions: our DXA-derived measure of rKOA demonstrated a progressive relationship with clinical outcomes. These findings support the use of DXA for classifying rKOA in large epidemiological studies and in future population-based screening.
DXA, knee osteoarthritis, radiographic osteoarthritis
rkaf009
Beynon, Rhona A.
3f5146c8-a3ea-4e9c-a983-0595b269b485
Saunders, Fiona R.
a51cc79d-0928-4ab6-a479-3972c974670b
Ebsim, Raja
fa3d2f2c-9d77-4b95-b0ff-c34b57142381
Faber, Benjamin G.
8639d027-09db-48fe-8213-0ab271f9701c
Jung, Mijin
de4a22aa-777b-47e8-8384-5b18b48b64a2
Gregory, Jennifer S.
6995d8fa-b32b-4f7c-aa15-8146acb4fd67
Lindner, Claudia
03ee5726-0741-4170-8375-659292641028
Aspden, Richard M.
71d1c790-5d9f-40b4-9130-bf7781b0e0dd
Harvey, Nicholas C.
ce487fb4-d360-4aac-9d17-9466d6cba145
Cootes, Timothy
f82f878a-ab1d-426c-9510-afa3f6de7aef
Tobias, Jonathan H.
514342d7-3491-4a7b-bbeb-b00dcf244daa
22 February 2025
Beynon, Rhona A.
3f5146c8-a3ea-4e9c-a983-0595b269b485
Saunders, Fiona R.
a51cc79d-0928-4ab6-a479-3972c974670b
Ebsim, Raja
fa3d2f2c-9d77-4b95-b0ff-c34b57142381
Faber, Benjamin G.
8639d027-09db-48fe-8213-0ab271f9701c
Jung, Mijin
de4a22aa-777b-47e8-8384-5b18b48b64a2
Gregory, Jennifer S.
6995d8fa-b32b-4f7c-aa15-8146acb4fd67
Lindner, Claudia
03ee5726-0741-4170-8375-659292641028
Aspden, Richard M.
71d1c790-5d9f-40b4-9130-bf7781b0e0dd
Harvey, Nicholas C.
ce487fb4-d360-4aac-9d17-9466d6cba145
Cootes, Timothy
f82f878a-ab1d-426c-9510-afa3f6de7aef
Tobias, Jonathan H.
514342d7-3491-4a7b-bbeb-b00dcf244daa
Beynon, Rhona A., Saunders, Fiona R., Ebsim, Raja, Faber, Benjamin G., Jung, Mijin, Gregory, Jennifer S., Lindner, Claudia, Aspden, Richard M., Harvey, Nicholas C., Cootes, Timothy and Tobias, Jonathan H.
(2025)
A novel classifier of radiographic knee osteoarthritis for use on knee DXA images is predictive of joint replacement in UK Biobank.
Rheumatology Advances in Practice, 9 (1), , [rkaf009].
(doi:10.1093/rap/rkaf009).
Abstract
Objectives: DXA scans may offer a novel means of evaluating radiographic knee OA (rKOA) in large population studies and through opportunistic screening. We aimed to develop and apply a semi-automated method for assessing rKOA using ≈20 000 knee DXA images from UK Biobank (UKB) and assess its face validity by checking for expected relationships with clinical outcomes.
Methods: right knee DXA scans were manually annotated for osteophytes to derive corresponding grades. Joint space narrowing (JSN) grades in the medial joint compartment were determined from automatically measured minimum joint space width. Overall rKOA grade (0-4) was determined by combining osteophyte and JSN grades. Logistic regression was employed to investigate the associations of osteophyte, JSN and rKOA grades with knee pain and hospital-diagnosed KOA. Cox proportional hazards modelling was used to examine the associations of these variables with risk of subsequent total knee replacement (TKR).
Results: of the 19 595 participants included (mean age 63.7 years), 19.5% had rKOA grade ≥1 (26.1% female, 12.5% male). Grade ≥1 osteophytes and grade ≥1 JSN were associated with knee pain, hospital-diagnosed KOA and TKR. Higher rKOA grades were linked to stronger associations with these clinical outcomes, with the most pronounced effects observed for TKR. Hazard ratios for the association of rKOA grades with TKR were 3.28, 8.75 and 28.63 for grades 1, 2 and 3-4, respectively.
Conclusions: our DXA-derived measure of rKOA demonstrated a progressive relationship with clinical outcomes. These findings support the use of DXA for classifying rKOA in large epidemiological studies and in future population-based screening.
Text
rkaf009
- Version of Record
More information
Accepted/In Press date: 17 December 2024
e-pub ahead of print date: 20 January 2025
Published date: 22 February 2025
Additional Information:
For the purpose of open access, the authors have applied a CC BY public copyright licence to any author accepted manuscript version arising from this submission.
Keywords:
DXA, knee osteoarthritis, radiographic osteoarthritis
Identifiers
Local EPrints ID: 499453
URI: http://eprints.soton.ac.uk/id/eprint/499453
PURE UUID: f3f5c18e-9a6b-4f2c-b9f0-d87ef5c78fee
Catalogue record
Date deposited: 20 Mar 2025 17:49
Last modified: 22 Aug 2025 01:52
Export record
Altmetrics
Contributors
Author:
Rhona A. Beynon
Author:
Fiona R. Saunders
Author:
Raja Ebsim
Author:
Benjamin G. Faber
Author:
Mijin Jung
Author:
Jennifer S. Gregory
Author:
Claudia Lindner
Author:
Richard M. Aspden
Author:
Timothy Cootes
Author:
Jonathan H. Tobias
Download statistics
Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.
View more statistics
