The Offspring members underwent bilateral posteroanterior hand radiographs at baseline (1992–1995) and follow-up (2002–2005), and one musculoskeletal radiologist (PA) read the paired radiographs with known time sequence. The Community members underwent bilateral posteroanterior hand radiographs at baseline (2002–2005), and one investigator (IKH) read the radiographs after a training session with PA and DTF.
The bilateral second to fifth distal interphalangeal (DIP), second to fifth proximal interphalangeal (PIP), first to fifth MCP, thumb interphalangeal (IP), thumb base (carpometacarpal/scaphotrapezial joint) and wrist joints were graded for HOA. We used a modified Kellgren–Lawrence (KL) Scale: KL grade (KLG) 0=no HOA; 1=minimal HOA, i.e. questionable osteophyte (OP) and/or joint space narrowing (JSN); 2=mild HOA, i.e. small OP(s) and/or mild JSN, sclerosis may be present; 3=moderate HOA, i.e. moderate OP(s) and/or moderate JSN, sclerosis and erosions may be present; 4=severe HOA, i.e. large OP(s) and/or severe JSN, sclerosis and erosions may be present.6 (link) The joints were also scored for absence/presence of subchondral erosions.30 (link)The same reader scored 42 randomly selected Offspring radiographs and 20 Community radiographs twice. Also, both readers scored 20 Community radiographs. Intra-reader and inter-reader reliability assessed by κ and intraclass correlation coefficients (two-way mixed effect model) were ‘good’ to ‘excellent’ (online supplementary table S1 ).31
The bilateral second to fifth distal interphalangeal (DIP), second to fifth proximal interphalangeal (PIP), first to fifth MCP, thumb interphalangeal (IP), thumb base (carpometacarpal/scaphotrapezial joint) and wrist joints were graded for HOA. We used a modified Kellgren–Lawrence (KL) Scale: KL grade (KLG) 0=no HOA; 1=minimal HOA, i.e. questionable osteophyte (OP) and/or joint space narrowing (JSN); 2=mild HOA, i.e. small OP(s) and/or mild JSN, sclerosis may be present; 3=moderate HOA, i.e. moderate OP(s) and/or moderate JSN, sclerosis and erosions may be present; 4=severe HOA, i.e. large OP(s) and/or severe JSN, sclerosis and erosions may be present.6 (link) The joints were also scored for absence/presence of subchondral erosions.30 (link)The same reader scored 42 randomly selected Offspring radiographs and 20 Community radiographs twice. Also, both readers scored 20 Community radiographs. Intra-reader and inter-reader reliability assessed by κ and intraclass correlation coefficients (two-way mixed effect model) were ‘good’ to ‘excellent’ (
