The posterior–anterior flexed view is better than the anterior–posterior view for assessing osteoarthritis of the knee

Kilian Rueckl, Friedrich Boettner, Noor Maza, Armin Runer, Ulrich Bechler, Peter Sculco

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Objective: The aim of this study is to determine whether the posterior–anterior (PA)-flexed view improves the radiographic assessment of patients with knee pain compared with the standard standing anterior–posterior radiograph. Materials and methods: Three hundred and sixty-five patients with knee pain underwent anterior–posterior (AP), PA flexed, lateral, and Merchant radiographs of the knee. Knees were grouped as mild (Kellgren and Lawrence [K-L] 1–2) or severe (K-L 3–4) osteoarthritis (OA) and either varus (medial compartment), valgus (lateral compartment), or patellofemoral OA. Results: In knees with mild valgus OA on AP view (K–L 1–2), the PA flexed view was more sensitive than the AP view. The measured lateral minimal joint space width (minJSW) decreased more than 2 mm in 68% of the patients, resulting in an increase in K–L grade (3 or 4). In patients with severe valgus OA and in all patients with varus and patellofemoral OA, there was no difference between AP and PA flexed view with regard to radiographic measurements or KL grade. Based on the Medicare reimbursement rate using the PA flexed view alone instead of both views reduced imaging costs by 47%. Conclusion: The PA flexed view better classifies the severity of lateral compartment disease in patients with mild valgus OA and provides comparable diagnostic sensitivity for joint space narrowing in varus- and patellofemoral OA. Using the PA flexed view alone was more cost effective than using the combination of AP and PA flexed imaging.

Original languageEnglish
Pages (from-to)511-517
Number of pages7
JournalSkeletal Radiology
Volume47
Issue number4
DOIs
StatePublished - 1 Apr 2018

Keywords

  • Assessment
  • Cost
  • Osteoarthritis
  • PA flexed view
  • Valgus

Fingerprint

Dive into the research topics of 'The posterior–anterior flexed view is better than the anterior–posterior view for assessing osteoarthritis of the knee'. Together they form a unique fingerprint.

Cite this