{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:33:15Z","timestamp":1787009595561,"version":"build-2736575974"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,1,20]],"date-time":"2025-01-20T00:00:00Z","timestamp":1737331200000},"content-version":"vor","delay-in-days":33,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,12,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>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 \u224820\u200a000 knee DXA images from UK Biobank (UKB) and assess its face validity by checking for expected relationships with clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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\u20134) 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).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 19\u200a595 participants included (mean age 63.7\u2009years), 19.5% had rKOA grade \u22651 (26.1% female, 12.5% male). Grade \u22651 osteophytes and grade \u22651 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\u20134, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/rap\/rkaf009","type":"journal-article","created":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T06:20:51Z","timestamp":1737094851000},"source":"Crossref","is-referenced-by-count":1,"title":["A novel classifier of radiographic knee osteoarthritis for use on knee DXA images is predictive of joint replacement in UK Biobank"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5494-9519","authenticated-orcid":false,"given":"Rhona A","family":"Beynon","sequence":"first","affiliation":[{"name":"Musculoskeletal Research Unit, Bristol Medical School, University of Bristol , Bristol,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiona R","family":"Saunders","sequence":"additional","affiliation":[{"name":"Centre for Arthritis and 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Aberdeen,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8194-2512","authenticated-orcid":false,"given":"Nicholas C","family":"Harvey","sequence":"additional","affiliation":[{"name":"Medical Research Council Lifecourse Epidemiology Centre, University of Southampton , Southampton,","place":["UK"]},{"name":"NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust , Southampton,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Cootes","sequence":"additional","affiliation":[{"name":"Division of Informatics, Imaging and Data Sciences, School of Health Sciences, University of Manchester , Manchester,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan H","family":"Tobias","sequence":"additional","affiliation":[{"name":"Musculoskeletal Research Unit, Bristol Medical School, 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