Test-retest reliability of joint space width measurements using the standardized MOST4 XFI knee radiography protocol.

Authors

Nasim Nosrati Nia, John A Lynch, Michael C Nevitt, Naga Harshita Degala, Neil A Segal

Published in

Osteoarthritis imaging. Pages 100480. Oct 30, 2026. Epub Oct 30, 2026.

Abstract

To evaluate the short-term test-retest reliability of two-dimensional joint space width (JSW) measurements acquired using the standardized Multicenter Osteoarthritis Study (MOST) radiographic protocol with a cone-beam CT system.
This cross-sectional, observational test-retest reliability study included 14 adults (28 knees) aged 50-79 years with Kellgren-Lawrence grades 0-4 who met MOST inclusion criteria. Bilateral posteroanterior weight-bearing radiographs were acquired using an XFI scanner (Planmed Oy, Helsinki, Finland) with a tilted Perspex positioning frame to align the tibial plateau parallel to the central X-ray beam. JSW was measured at 50-90% of the distance from the tibial spine to the outer tibial plateau in both the medial and lateral tibiofemoral compartments. Test-retest reliability over a two-week interval was assessed using Shrout-Fleiss intraclass correlation coefficients (ICC(2,1)) and limits of agreement (LoA).
Medial compartment JSW measurements demonstrated excellent test-retest reliability, with ICCs ranging from 0.92 to 0.96. Lateral compartment measurements showed good reliability, with ICCs ranging from 0.76 to 0.87. The narrowest LoA were observed at the 80% measurement location in the medial compartment (-0.81 to 0.62 mm) and at the 90% location in the lateral compartment (-0.14 to 2.26 mm).
The MOST XFI radiographic protocol provides reliable and standardized measurements of tibiofemoral JSW in both the medial and lateral compartments. These findings support its use in longitudinal studies and clinical research evaluating structural progression and therapeutic response in knee osteoarthritis.

PMID:
43003752
Bibliographic data and abstract were imported from PubMed on 10 Nov 2026.

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