Selection of knee radiographs for trials of structure-modifying drugs in patients with knee osteoarthritis: a prospective, longitudinal study of Lyon Schuss knee radiographs with the definition of adequate alignment of the medial tibial plateau.

Objective: The quality of medial tibial plateau (MTP) alignment, which is assessed by measuring the distance between the anterior and posterior margins (intermargin distance [IMD]) of the tibial plateau, and the reproducibility of alignment in serial radiographs are suggested to be key elements in determining the accuracy and sensitivity to change in knee radiographs in patients with tibiofemoral osteoarthritis (OA). We evaluated the influence of both MTP alignment and radiograph superimposition on the sensitivity to change in radiographic joint space narrowing (JSN) in knee OA.

Methods: The study group comprised 106 patients with knee pain (73 with OA).

Lyon Schuss radiographic view of the knee. Utility of fluoroscopy for the quality of tibial plateau alignment.

Objective: The "Lyon schuss" (LS) view is a fluoroscopically assisted radiographic technique of the knee in flexion. The quality of medial tibial plateau (MTP) alignment is a key element for accuracy and sensitivity to change of knee radiography. We collected data on the geometry of the osteoarthritic (OA) knee when positioned under fluoroscopy according to the LS protocol, then applied the results to develop an angulation standard for a nonfluoroscopically guided examination, and evaluated the performance of fluoroscopic and nonfluoroscopic alternatives for good alignment of the MTP.