Baseline 3D joint space width on weight-bearing CT in comparison with 2D JSW_x on radiographs for predicting 24-month worsening of knee structure in the multicenter osteoarthritis study.

Authors

Ryo Yoshikawa, Ali Guermazi, Irina Tolstykh, Donald D Anderson, John A Lynch, Jeffrey Duryea, Frank Roemer, Michael C Nevitt, Neil A Segal

Published in

Osteoarthritis imaging. Volume 6. Issue 2. Epub Jun 10, 2026.

Abstract

This study evaluated the predictive validity of baseline 3D joint space width (3D-JSW) measured using weight-bearing computed tomography (WBCT) versus 2D-JSW on radiographs for predicting knee structural worsening over 24 months, assessed by radiographs and MRI.
A prospective observational study using data from the Multicenter Osteoarthritis Study (MOST) included 425 knees. Baseline 3D-JSW was assessed using WBCT acquired in a standing fixed-flexion position, and 2D-JSW was assessed from standing fixed-flexion posteroanterior radiographs. Outcomes included 24-month changes in tibiofemoral Osteoarthritis Research Society International (OARSI) joint space narrowing (JSN) grade and MRI Osteoarthritis Knee Score Cartilage Morphology (MOAKS-CM). Predictive validity was evaluated using logistic regression and comparison of areas under ROC curves.
The study population (N=302) had a mean age of 63.2 years (standard deviation 8.9) and BMI of 28.2 kg/m² (standard deviation 4.8), with radiographic OA observed in 45.9 %. For medial JSN worsening, 2D-JSW (AUC=0.711) showed significantly better predictive validity than the basic demographic model (AUC=0.626, p=0.032), while 3D-JSW (AUC=0.681) did not outperform 2D-JSW (p=0.184). For lateral JSN worsening, 3D-JSW (AUC=0.900) and 2D-JSW (AUC=0.893) were similar (p=0.814). For medial MOAKS-CM worsening, 3D-JSW (AUC=0.729) and 2D-JSW (AUC=0.742) were similar (p=0.579), as were 3D-JSW (AUC=0.699) and 2D-JSW (AUC=0.692) for lateral worsening (p=0.779).
3D-JSW did not show superior predictive validity over 2D-JSW in predicting knee structural worsening over 24 months in a cohort predominatly without radiographic knee OA. WBCT remains a promising imaging modality for osteoarthritis assessment. Further studies are needed to determine its role as a diagnostic tool.

PMID:
42422262
Bibliographic data and abstract were imported from PubMed on 09 Jul 2026.

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