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Concordance between clinical and radiographic evaluations of knee osteoarthritis

Concordance between clinical and radiographic evaluations of knee osteoarthritis
Concordance between clinical and radiographic evaluations of knee osteoarthritis
Background:

Significant correlation has been previously demonstrated between radiographic and clinical diagnoses of knee osteoarthritis (OA); however, the specific findings on clinical examination that relate best to a radiographic diagnosis have not been fully elicited.

Aims:

We aimed to explore the relationship between clinical symptoms and physical findings with radiographic diagnoses of tibiofemoral and patellofemoral OA.

Methods:

This study was based on 409 individuals from the Hertfordshire Cohort Study, born between 1931 and 1939. Antero-posterior and lateral radiographs were taken of both knees. The presence of tibiofemoral and patellofemoral OA was defined according to the Kellgren and Lawrence score. Clinical symptoms, assessed using WOMAC, and physical findings were ascertained by examination. Relationships were assessed using multilevel univariate logistic regression.

Results:

In the 775 knees studied, the prevalence of physical findings was crepitus (25%), tibiofemoral tenderness (15%), bony swelling (12%), and pain on flexion (10%). Thirty-one percent (n = 238) knees demonstrated tibiofemoral OA, 28% (n = 220) showed patellofemoral OA, and 16% demonstrated OA in both locations. A global clinical symptom score was associated with increased risk of tibiofemoral OA (OR 12.5, 95% CI 5.4–29.0) and patellofemoral OA (OR 5.1, 95% CI 2.3–13.1). On clinical examination, the presence of crepitus, tibiofemoral tenderness, bony swelling, and pain on flexion was associated with increased risk of tibiofemoral OA; however, only tenderness was found to be associated with patellofemoral OA.

Conclusion:

Global clinical symptom score was associated with radiographic tibiofemoral and patellofemoral OA. However, individual clinical signs were more strongly associated with tibiofemoral than patellofemoral OA.
1594-0667
17-25
Parsons, Camille
9730e5c3-0382-4ed7-8eaa-6932ab09ec15
Fuggle, Nicholas R.
512794d2-cfcb-41ca-b150-8312dba7b54a
Edwards, Mark H.
8d92e1ef-8d4d-4efa-a183-305cd9ca1125
Goulston, Lyndsey
8ec92e10-7177-4583-b5bd-4e3bd6cc1bc6
Litwic, Anna E.
29681876-5b79-4672-8325-f857b87c4761
Jagannath, Darshan
8af741cd-50b5-4fc4-8d51-b26c54e295f9
van der Pas, Suzan
b757cbc1-7c27-4c2a-b96c-e24e44aad0b9
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Dennison, Elaine M.
ee647287-edb4-4392-8361-e59fd505b1d1
EPOSA Research Group
Parsons, Camille
9730e5c3-0382-4ed7-8eaa-6932ab09ec15
Fuggle, Nicholas R.
512794d2-cfcb-41ca-b150-8312dba7b54a
Edwards, Mark H.
8d92e1ef-8d4d-4efa-a183-305cd9ca1125
Goulston, Lyndsey
8ec92e10-7177-4583-b5bd-4e3bd6cc1bc6
Litwic, Anna E.
29681876-5b79-4672-8325-f857b87c4761
Jagannath, Darshan
8af741cd-50b5-4fc4-8d51-b26c54e295f9
van der Pas, Suzan
b757cbc1-7c27-4c2a-b96c-e24e44aad0b9
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Dennison, Elaine M.
ee647287-edb4-4392-8361-e59fd505b1d1

Parsons, Camille, Fuggle, Nicholas R., Edwards, Mark H., Goulston, Lyndsey, Litwic, Anna E., Jagannath, Darshan, van der Pas, Suzan, Cooper, Cyrus and Dennison, Elaine M. , EPOSA Research Group (2018) Concordance between clinical and radiographic evaluations of knee osteoarthritis. Aging Clinical and Experimental Research, 30 (1), 17-25. (doi:10.1007/s40520-017-0847-z).

Record type: Article

Abstract

Background:

Significant correlation has been previously demonstrated between radiographic and clinical diagnoses of knee osteoarthritis (OA); however, the specific findings on clinical examination that relate best to a radiographic diagnosis have not been fully elicited.

Aims:

We aimed to explore the relationship between clinical symptoms and physical findings with radiographic diagnoses of tibiofemoral and patellofemoral OA.

Methods:

This study was based on 409 individuals from the Hertfordshire Cohort Study, born between 1931 and 1939. Antero-posterior and lateral radiographs were taken of both knees. The presence of tibiofemoral and patellofemoral OA was defined according to the Kellgren and Lawrence score. Clinical symptoms, assessed using WOMAC, and physical findings were ascertained by examination. Relationships were assessed using multilevel univariate logistic regression.

Results:

In the 775 knees studied, the prevalence of physical findings was crepitus (25%), tibiofemoral tenderness (15%), bony swelling (12%), and pain on flexion (10%). Thirty-one percent (n = 238) knees demonstrated tibiofemoral OA, 28% (n = 220) showed patellofemoral OA, and 16% demonstrated OA in both locations. A global clinical symptom score was associated with increased risk of tibiofemoral OA (OR 12.5, 95% CI 5.4–29.0) and patellofemoral OA (OR 5.1, 95% CI 2.3–13.1). On clinical examination, the presence of crepitus, tibiofemoral tenderness, bony swelling, and pain on flexion was associated with increased risk of tibiofemoral OA; however, only tenderness was found to be associated with patellofemoral OA.

Conclusion:

Global clinical symptom score was associated with radiographic tibiofemoral and patellofemoral OA. However, individual clinical signs were more strongly associated with tibiofemoral than patellofemoral OA.

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More information

Accepted/In Press date: 9 October 2017
e-pub ahead of print date: 3 November 2017
Published date: January 2018

Identifiers

Local EPrints ID: 415361
URI: https://eprints.soton.ac.uk/id/eprint/415361
ISSN: 1594-0667
PURE UUID: a4912cad-f03e-4656-a914-5b62861956c5
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709

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Date deposited: 08 Nov 2017 17:30
Last modified: 26 Mar 2018 16:31

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Contributors

Author: Camille Parsons
Author: Nicholas R. Fuggle
Author: Mark H. Edwards
Author: Lyndsey Goulston
Author: Anna E. Litwic
Author: Darshan Jagannath
Author: Suzan van der Pas
Author: Cyrus Cooper ORCID iD

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